Active management of third stage of labour with low doses of oral misoprostol and oxytocin on low: risk parturient in a Sub-Saharan hospital, Dakar, Sénégal

Diallo, Moussa; Sylla, Toura; Diouf, Abdoul Aziz; Moreira, Phillipe Marc; Gassama, Omar; M, Gueye; Dieme, Marie Edouard Faye; Niang, Mouhamadou Mansour; Moreau, Jean Charles; Diouf, Alassane

doi:10.18203/2320-1770.ijrcog20170373

Cited by 4 publications

(3 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Studies from other underdeveloped and developing countries report similar findings [14,15], despite showing the higher amount of blood loss, the need for additional uterotonics, and the adverse effects in the misoprostol group. They have mainly focused on statistical differences in a smaller sample size scenario.…”

Section: Discussionmentioning

confidence: 58%

A Comparative Study of Sublingual Misoprostol Versus Intramuscular Oxytocin in the Active Management of Third Stage of Labor

Mishra¹,

Tirkey²,

Prasad³

et al. 2023

Cureus

View full text Add to dashboard Cite

Misoprostol has attracted low-income low-resource countries for the active management of the third stage of labor. The objective of this study was to compare the efficacy of sublingual misoprostol and intramuscular oxytocin in the active management of the third stage of labor. Study designThis was a prospective randomized controlled trial in which a total of 407 healthy pregnant women having singleton pregnancy, cephalic presentation, and normal vaginal delivery were divided into two groups. In the first group (n=203), women received 600 µg misoprostol tablet sublingually, and in the second group (n=204), women received 10 IU of intramuscular oxytocin, within 1 minute of the delivery of the baby during the third stage of labor. Three patients from the first group and four patients from the second group were excluded from the analysis due to traumatic postpartum hemorrhage (PPH). The primary outcome was an incidence of PPH. Secondary outcomes were the duration of the third stage of labor, amount of blood loss, fall in hemoglobin concentration after 48 hours of delivery, need for additional uterotonics, and side effects of the drugs. Data were compared using the chi-square and independent samples t-test. ResultsThe incidence of PPH was 6.5% in the misoprostol group as compared to 2% in the oxytocin group (p=0.026). The misoprostol group also had significantly higher blood loss (293.75±125.8 mL) and a greater fall in hemoglobin level (0.58±0.25 g/dL) as compared to that in the oxytocin group (226.13±98.44 mL and 0.45±0.20 g/dL) (p<0.001). The mean duration of the third stage of labor was significantly higher in the misoprostol group (5.31±2.1 min) as compared to that in the oxytocin group (3.65±1.75 min) (p<0.001). The additional need for uterotonics was recorded in 15% of the study participants in the misoprostol group as compared to 8% in the oxytocin group (p=0.028). The incidence of side effects such as shivering and fever was significantly higher in the misoprostol group as compared to the oxytocin group. No significant difference between the two groups was observed concerning the incidence of nausea, vomiting, diarrhea, and headache. ConclusionIntramuscular oxytocin is a safe and useful alternative to sublingual misoprostol in facilitating the third stage of labor with minimal blood loss, fewer incidences of hemorrhage, and fewer adverse effects.

show abstract

Section: Discussionmentioning

confidence: 58%

A Comparative Study of Sublingual Misoprostol Versus Intramuscular Oxytocin in the Active Management of Third Stage of Labor

Mishra¹,

Tirkey²,

Prasad³

et al. 2023

Cureus

View full text Add to dashboard Cite

show abstract

“…The frequency of side effects was also significantly higher in the misoprostol group than in the oxytocin group. Studies in other underdeveloped and developing countries have reported similar results [22,23] but the misoprostol group showed greater blood loss, the need for additional uterotonics, and side effects has been done. They mainly focused on statistical differences in small sample size scenarios.…”

Section: Discussionmentioning

confidence: 84%

Misoprostol versus oxytocin in reducing postpartum hemorrhage after labor induction

Akter,

Manjuri

2024

Int. J. Clin. Obstet. Gynaecol.

View full text Add to dashboard Cite

Introduction: Postpartum haemorrhage is the most serious complication in obstetric practice. The greatest number of maternal deaths from haemorrhage is due to PPH, which is almost entirely a preventable condition. WHO defines PPH as blood loss of 500 ml or more in first 24 hours post-partum. PPH is one of the most common obstetric maternal complications and is among the three most common etiologies of maternal death worldwide. Objective: To compare misoprostol versus oxytocin in reducing postpartum hemorrhage after labor induction. Methods:The study was a randomized clinical trial carried out at the

show abstract

“…The efficacy of misoprostol alone as well as an adjunct to oxytocin for prevention of PPH is well documented. [9][10][11][12][13][14][15][16][17][18][19][20] In contrast very few studies have reported a contrary view but have used a lower dose. 21 Choosing the optimal dose is imperative to achieve the goal as discussed later.…”

Section: Discussionmentioning

confidence: 99%

Adjunctive misoprostol for prevention of post-partum haemorrhage: a pragmatic strategy of selective sequential administration

Mishra

Nekkanti

Barma

et al. 2021

Int J Reprod Contracept Obstet Gynecol

View full text Add to dashboard Cite

Background: To evaluate the effect of adjunctive misoprostol in preventing postpartum haemorrhage (PPH) by selective administration above threshold bleeding in order to reduce its side effects in comparison with primary prevention with oxytocin alone.Methods: It was a prospective observational cohort study conducted at Government medical College of central India. Population included 500 low risk women delivering vaginally. After having received oxytocin as primary prevention, women were monitored for bleeding by quantitative assessment of blood loss (QBL) using an innovative drape (kept prepared at the point of care) and once bleeding crossed 350 ml mark, alternate women were given 800 µg misoprostol sublingually as an adjuvant (study group) and compared with those who did not receive adjuvant misoprostol (control group). Main outcome measure: Comparing the incidence of PPH and side effects between study and control group.Results: 150 women had blood loss >350 ml which constituted 76 women in study and control group each. Incidence of PPH was significantly less in the study group (10.52 versus 22.36%, p<0.05, RR 0.470 95% CI= 0.216-1.024). Though side effects were more (38.15%) in study group but these were mild in nature and when the number was extrapolated to all recruited women, the incidence came down to 11.6%.Conclusions: Sequential adjuvant misoprostol at 350 ml blood loss after primary prevention with oxytocin is an effective and pragmatic strategy for preventing PPH when compared to oxytocin alone but with reduced overall side effects owing to less number of women receiving misoprostol.

show abstract

Active management of third stage of labour with low doses of oral misoprostol and oxytocin on low: risk parturient in a Sub-Saharan hospital, Dakar, Sénégal

Cited by 4 publications

References 20 publications

A Comparative Study of Sublingual Misoprostol Versus Intramuscular Oxytocin in the Active Management of Third Stage of Labor

A Comparative Study of Sublingual Misoprostol Versus Intramuscular Oxytocin in the Active Management of Third Stage of Labor

Misoprostol versus oxytocin in reducing postpartum hemorrhage after labor induction

Adjunctive misoprostol for prevention of post-partum haemorrhage: a pragmatic strategy of selective sequential administration

Contact Info

Product

Resources

About