Prostaglandins for prevention of postpartum haemorrhage

Am, Gülmezoğlu; Forna, Fatu; Villar, José; Hofmeyr, G Justus

doi:10.1002/14651858.cd000494

Cited by 37 publications

(19 citation statements)

References 47 publications

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“…They found that 600 mg of misoprostol was less effective than oxytocin in preventing postpartum hemorrhage greater than 1000 mL (RR, 1.36; 95% CI, 1.17-1.58). 32 It was found that 3.6% of those given 600 mg misoprostol had a blood loss greater than 500 mL compared to 2.6% of those given oxytocin. 32 These results can be interpreted as meaning that, for every 100 women given misoprostol instead of oxytocin, one of them will experience blood loss greater than 1000 mL.…”

Section: Uterotonics For Prevention Of Postpartum Hemorrhagementioning

confidence: 98%

“…32 It was found that 3.6% of those given 600 mg misoprostol had a blood loss greater than 500 mL compared to 2.6% of those given oxytocin. 32 These results can be interpreted as meaning that, for every 100 women given misoprostol instead of oxytocin, one of them will experience blood loss greater than 1000 mL. Again, however, there was no difference in clinically relevant outcomes such as need for transfusion.…”

Section: Uterotonics For Prevention Of Postpartum Hemorrhagementioning

confidence: 99%

See 1 more Smart Citation

CEU: Prevention and Treatment of Postpartum Hemorrhage: New Advances for Low‐Resource Settings

Miller¹,

Lester²,

Hensleigh

2004

J Midwife Womens Health

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Postpartum hemorrhage due to uterine atony is the primary direct cause of maternal mortality globally. Management strategies in developed countries involve crystalloid fluid replacement, blood transfusions, and surgery. These definitive therapies are often not accessible in developing countries. Long transports from home or primary health care facilities, a dearth of skilled providers, and lack of intravenous fluids and/or a safe blood supply often create long delays in instituting appropriate treatment. We review the evidence for active management of third-stage labor and for the use of specific uterotonics. New strategies to prevent and manage postpartum hemorrhage in developing countries, such as community-based use of misoprostol, oxytocin in the Uniject delivery system, the non-inflatable antishock garment to stabilize and resuscitate hypovolemic shock, and the balloon condom catheter to treat intractable uterine bleeding are reviewed. New directions for clinical and operations research are suggested.

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Section: Uterotonics For Prevention Of Postpartum Hemorrhagementioning

confidence: 98%

Section: Uterotonics For Prevention Of Postpartum Hemorrhagementioning

confidence: 99%

CEU: Prevention and Treatment of Postpartum Hemorrhage: New Advances for Low‐Resource Settings

Miller¹,

Lester²,

Hensleigh

2004

J Midwife Womens Health

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“…A final option is PGE2, which is administered 20 mg rectally with repetition, as necessary every 2 hours. Unfortunately, it has an unfavorable side effect profile that includes fever, chills, nausea, vomiting, diarrhea and headaches [24]. …”

Section: Escalated Medical Managementmentioning

confidence: 99%

Emergent management of postpartum hemorrhage for the general and acute care surgeon

et al. 2009

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BackgroundPostpartum hemorrhage is one of the rare occasions when a general or acute care surgeon may be emergently called to labor and delivery, a situation in which time is limited and the stakes high. Unfortunately, there is generally a paucity of exposure and information available to surgeons regarding this topic: obstetric training is rarely found in contemporary surgical residency curricula and is omitted nearly completely from general and acute care surgery literature and continuing medical education.MethodsThe purpose of this manuscript is to serve as a topic specific review for surgeons and to present a surgeon oriented management algorithm. Medline and Ovid databases were utilized in a comprehensive literature review regarding the management of postpartum hemorrhage and a management algorithm for surgeons developed based upon a collaborative panel of general, acute care, trauma and obstetrical surgeons' review of the literature and expert opinion.ResultsA stepwise approach for surgeons of the medical and surgical interventions utilized to manage and treat postpartum hemorrhage is presented and organized into a basic algorithm.ConclusionThe manuscript should promote and facilitate a more educated, systematic and effective surgeon response and participation in the management of postpartum hemorrhage.

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“…11 When administered in various doses and via various routes for the prevention of postpartum haemorrhage, misoprostol has been less effective than conventional injectable uterotonics. 12,13 Initial reports of placebo-controlled trials have shown variable results, 12 but in more recent studies misoprostol has proved better than placebo, in terms of measured blood loss, for both the prevention 14,15 and treatment 16 of postpartum haemorrhage. The main side effects reported have been chills and pyrexia, both of which have been dose-dependent.…”

Section: Introductionmentioning

confidence: 99%

Misoprostol to prevent and treat postpartum haemorrhage: a systematic review and meta-analysis of maternal deaths and dose-related effects

Hofmeyr¹,

Gülmezoglu²,

Novikova³

et al. 2009

Bull World Health Org

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Objective To review maternal deaths and the dose-related effects of misoprostol on blood loss and pyrexia in randomized trials of misoprostol use for the prevention or treatment of postpartum haemorrhage. Methods We searched the Cochrane Controlled Trials Register and Pubmed, without language restrictions, for "(misoprostol AND postpartum) OR (misoprostol AND haemorrhage) OR (misoprostol AND hemorrhage)", and we evaluated reports identified through the Cochrane Pregnancy and Childbirth Group search strategy. Randomized trials comparing misoprostol with either placebo or another uterotonic to prevent or treat postpartum haemorrhage were checked for eligibility. Data were extracted, tabulated and analysed with Reviewer Manager (RevMan) 4.3 software. Findings We included 46 trials with more than 40 000 participants in the final analysis. Of 11 deaths reported in 5 trials, 8 occurred in women receiving ³ 600 µg of misoprostol (Peto odds ratio, OR: 2.49; 95% confidence interval, CI: 0.76-8.13). Severe morbidity, defined as the need for major surgery, admission to intensive care, organ failure or body temperature ³ 40 °C, was relatively infrequent. In prevention trials, severe morbidity was experienced by 16 of 10 281 women on misoprostol and by 16 of 10 292 women on conventional uterotonics; in treatment trials, it was experienced by 1 of 32 women on misoprostol and by 1 of 32 women on conventional uterotonics. Misoprostol recipients experienced more adverse events than placebo recipients: 8 of 2070 versus 5 of 2032, respectively, in prevention trials, and 5 of 196 versus 2 of 202, respectively, in treatment trials. Meta-analysis of direct and adjusted indirect comparisons of the results of randomized trials showed no evidence that 600 µg are more effective than 400 µg for preventing blood loss ³ 1000 ml (relative risk, RR: 1.02; 95% CI: 0.71-1.48). Pyrexia was more than twice as common among women who received ³ 600 µg rather than 400 µg of misoprostol (RR: 2.53; 95% CI: 1.78-3.60). Conclusion Further research is needed to more accurately assess the potential beneficial and harmful effects of misoprostol and to determine the smallest dose that is effective and safe. In this review, 400 µg of misoprostol were found to be safer than ³ 600 µg and just as effective.Une traduction en français de ce résumé figure à la fin de l'article. Al final del artículo se facilita una traducción al español. ‫املقالة.‬ ‫لهذه‬ ‫الكامل‬ ‫النص‬ ‫نهاية‬ ‫يف‬ ‫الخالصة‬ ‫لهذه‬ ‫العربية‬ ‫الرتجمة‬

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Prostaglandins for prevention of postpartum haemorrhage

Cited by 37 publications

References 47 publications

CEU: Prevention and Treatment of Postpartum Hemorrhage: New Advances for Low‐Resource Settings

CEU: Prevention and Treatment of Postpartum Hemorrhage: New Advances for Low‐Resource Settings

Emergent management of postpartum hemorrhage for the general and acute care surgeon

Misoprostol to prevent and treat postpartum haemorrhage: a systematic review and meta-analysis of maternal deaths and dose-related effects

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