Preventing the recurrence of atonic postpartum hemorrhage: a double‐blind trial

Selm, Maria Van; Kanhai, Humphrey H.H.; Keirse, Marc J. N. C.

doi:10.3109/00016349509024448

Cited by 28 publications

(1 citation statement)

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“…In a recent placebo controlled, randomised trial published in this Journal , blood loss > 800 ml occurred in 8.8% of women who received oxytocin 101U, compared with 15.2% who received saline6. Sulprostone, a prostaglandin E analogue, is effective in pre‐ venting the recurrence of atonic postpartum haemorrhage 7 . Prostaglandin F 2 α has been used for the management of postpartum haemorrhage 8 .…”

Section: Introductionmentioning

confidence: 99%

A randomised placebo controlled trial of oral misoprostol in the third stage of labour

Hofmeyr

Nikodem

Jager

et al. 1998

BJOG

117

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Objective To compare oral misoprostol 400 pg with placebo in the routine management of the Design A double-blind placebo controlled trial. Setting The labour ward of an academic hospital in Johannesburg, South Africa with 7000Participants Low-risk women expected to deliver vaginally. Methods Women in labour were randomly allocated to receive either misoprosto1400 pg orally or placebo after the birth. Conventional oxytocics were given immediately if blood loss was thought to be more than usual. Postpartum blood loss in the first hour was measured by collection in a special flat plastic bedpan. Side effects were recorded.Main outcome measures Measured blood loss 2 1000 ml within the first hour after birth. Use of additional oxytocics.Results The groups were well matched. Measured blood loss 2 1000 ml occurred in 15/250 (6%) after misoprostol and 23/250 (9%) after placebo (relative risk 0.65; 95% confidence interval 0.35-1.22). The difference may have been reduced by the greater use of conventional oxytocics in the placebo group, which was statistically significant for intravenous oxytocin infusion (2.8% vs 8.4%, relative risk 0-33, 95% confidence interval 0.140.77). Shivering was more common in the misoprostol group (190/, vs 5%, relative risk 3.69; 95% confidence interval 2.05-6-64).Conclusions Shivering has been shown in this study to be a specific side effect of misoprostol administered orally in the puerperium. No serious side effects were noted. Misoprostol shows promise as a method of preventing postpartum haemorrhage. Because of the potential benefits for childbearing women, particularly those in developing countries, further research to determine its effects with greater certainty should be expedited.third stage of labour.deliveries per annum.

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Section: Introductionmentioning

confidence: 99%