Prophylactic use of ergot alkaloids in the third stage of labour

Liabsuetrakul, Tippawan; Choobun, Thanapan; Peeyananjarassri, Krantarat; Islam, Q Monir

doi:10.1002/14651858.cd005456.pub3

Cited by 34 publications

(24 citation statements)

References 82 publications

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“…11 Some authorities consider methylergometrine as second line drug for AMTSL compared to oxytocin. 17 Studies have shown that Misoprostol is not as effective as Oxytocin for the prevention of PPH and that maternal pyrexia is a significant adverse effect. 14,16,[18][19][20] However, misoprostol is a suitable agent for management of the third stage of labour when other agents are not available for reasons of cost, storage, or difficulty of administration.…”

Section: Discussionmentioning

confidence: 99%

A comparative study of efficacy of oxytocin, methylergometrine and misoprostol in prevention of post-partum haemorrhage

Alam

Shyam

Goswami

2017

Int J Reprod Contracept Obstet Gynecol

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Background: To compare the efficacy of oxytocin, methylergometrine and misoprostol in active management of third stage of labour (AMTSL).Methods: A clinical study was conducted on 330 low risk pregnant women with a healthy singleton pregnancy and spontaneous onset of labour at term; allocated into three groups where active management of third stage of labour was done with either Oxytocin 10 IU intramuscular, or Methylergometrine 0.2 mg intramuscular, or tab Misoprostol 600µg sublingual on 110 women each group. Primary parameter was blood loss during labour. Secondary parameters were the duration of third stage of labour and changes in haemoglobin level.Results: Blood loss during labour in Oxytocin group was 145.86±11.53 ml, which was significantly less than that in Methylergometrine (164.02±9.36 ml) and Misoprostol groups (183.18±9.70 ml), but no patient in any of the groups had blood loss more than 200ml. Duration of third stage of labour was significantly less in Oxytocin group (5.13±1.91 mins) than in. Methylergometrine (6.16±1.85 mins), and Misoprostol groups (6.47±1.51 mins). No patient had prolonged third stage in any of the groups. There was no significant change in pre-and post-delivery haemoglobin levels in all the groups.Conclusions: Though injectable uterotonics are effective for active management of third stage of labour (AMTSL), misoprostol can also be effectively used, especially in settings where there is no adequate trained personnel and drug storage facility.

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Section: Discussionmentioning

confidence: 99%

A comparative study of efficacy of oxytocin, methylergometrine and misoprostol in prevention of post-partum haemorrhage

Alam

Shyam

Goswami

2017

Int J Reprod Contracept Obstet Gynecol

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“…Intraumbilical administration of oxytocin was also found to cause significant reductions in blood loss [60,61]. Similarly for the use of other uterotonics, a 2011 review of ergot alkaloids containing six studies (RCTs and quasiRCTs) found a significant reduction of PPH when administered in third stage of labor [62].…”

Section: The International Confederation Of Midwives and Internationalmentioning

confidence: 96%

Postpartum Hemorrhage; a Major Killer of Woman: Review of Current Scenario

Kumar¹

2016

OGIJ

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Postpartum Hemorrhage is one of most common causes of maternal mortality worldwide accounting for 127,000 deaths annually. PPH is a preventable condition and early, timely intervention can prevent development of this dreadful condition. One such intervention that is highly recommended is Active Management of Third Stage of Labor. It is the only intervention known to prevent PPH. Though even with different interventions and blood transfusion facility, maternal deaths cannot be brought down to zero. Significant reduction can only be achieved by better education of women about maternal health. The main purpose of this study is to know the recent global and national prevalence of PPH, its prevention as well as management at an early stage, so as to reduce the overall burden of deaths resulting from PPH. Method:The literature regarding PPH was searched from various English language journals and published peer-reviewed articles on PubMed, MEDLINE, Embase and Google Scholar till 2015.

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“…Lower abdominal pain may be mild to severe, accompanied by back pain and is described as throbbing, cramping and aching. Ergot alkaloids during the third stage of labour increased the requirement for analgesia for pain after birth due to persistent uterine contraction (RR 2.53; CI 1.34 to 4.78), but also decreased mean blood loss and the incidence of postpartum haemorrhage compared with no uterotonic drugs (Liabsuetrakul et al, 2007 Level I).…”

Section: Uterine Painmentioning

confidence: 99%

Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non‐inferiority trial

Cohen

Smit

Andrianopoulos³

et al. 2017

Medical Journal of Australia

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Objectives: This study aimed to assess analgesia provided by acupuncture, alone or in combination with pharmacotherapy, to patients presenting to emergency departments with acute low back pain, migraine or ankle sprain. Design: A pragmatic, multicentre, randomised, assessor‐blinded, equivalence and non‐inferiority trial of analgesia, comparing acupuncture alone, acupuncture plus pharmacotherapy, and pharmacotherapy alone for alleviating pain in the emergency department. Setting, participants: Patients presenting to emergency departments in one of four tertiary hospitals in Melbourne with acute low back pain, migraine, or ankle sprain, and with a pain score on a 10‐point verbal numerical rating scale (VNRS) of at least 4. Main outcome measures: The primary outcome measure was pain at one hour (T1). Clinically relevant pain relief was defined as achieving a VNRS score below 4, and statistically relevant pain relief as a reduction in VNRS score of greater than 2 units. Results: 1964 patients were assessed between January 2010 and December 2011; 528 patients with acute low back pain (270 patients), migraine (92) or ankle sprain (166) were randomised to acupuncture alone (177 patients), acupuncture plus pharmacotherapy (178) or pharmacotherapy alone (173). Equivalence and non‐inferiority of treatment groups was found overall and for the low back pain and ankle sprain groups in both intention‐to‐treat and per protocol (PP) analyses, except in the PP equivalence testing of the ankle sprain group. 15.6% of patients had clinically relevant pain relief and 36.9% had statistically relevant pain relief at T1; there were no between‐group differences. Conclusion: The effectiveness of acupuncture in providing acute analgesia for patients with back pain and ankle sprain was comparable with that of pharmacotherapy. Acupuncture is a safe and acceptable form of analgesia, but none of the examined therapies provided optimal acute analgesia. More effective options are needed. Trial registration: Australian New Zealand Clinical Trials Registry, ACTRN12609000989246.

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Prophylactic use of ergot alkaloids in the third stage of labour

Abstract: Analysis 1.4. Comparison 1 Ergot alkaloids (any route of administration) versus no uterotonic agents, Outcome 4 Maternal haemoglobin concentration at 24 to 48 hours postpartum (g/dL

Cited by 34 publications

References 82 publications

A comparative study of efficacy of oxytocin, methylergometrine and misoprostol in prevention of post-partum haemorrhage

A comparative study of efficacy of oxytocin, methylergometrine and misoprostol in prevention of post-partum haemorrhage

Postpartum Hemorrhage; a Major Killer of Woman: Review of Current Scenario

Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non‐inferiority trial

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