RETRACTED ARTICLE: Rectal vs. sublingual misoprostol before cesarean section: double-blind, three-arm, randomized clinical trial

Sweed, Mohamed S.; El-Saied, Mourad M; Abou-Gamrah, Amgad E; El-Sabaa, Haitham; Abdel-Hamid, Mohamed M; Hemeda, Hosam; Mansour, Ahmed M.; Shawky, Mohamed; Elsayed, Medhat Adel; Mohamed, Radwa

doi:10.1007/s00404-018-4894-2

Cited by 8 publications

(17 citation statements)

References 21 publications

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“…Therefore, misoprostol can be considered as a drug to prevent postpartum hemorrhage in underdeveloped countries or remote areas. In recent years, a number of multicenter double-blind trials have been conducted to study the effect of misoprostol on the prevention of postpartum hemorrhage, but various studies have reported different results on the efficacy and safety of misoprostol, and the conclusions obtained are of limited reference value [ 7 – 9 ].…”

Section: Introductionmentioning

confidence: 99%

Comparison of Clinical Efficacy and Safety between Misoprostol and Oxytocin in the Prevention of Postpartum Hemorrhage: A Meta-Analysis

Guo

Zhang

et al. 2022

Journal of Healthcare Engineering

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In order to systematically evaluate the clinical efficacy and safety of misoprostol versus oxytocin in the prevention of postpartum hemorrhage, this paper provides evidence-based reference for clinical medication, computerized retrieval of Chinese biomedical literature database (CBM), PubMed, Embase, Cochrane Library, and clinical trials. The retrieval period is from the establishment of each database to October 1, 2021. Published randomized controlled trials (RCTS) are included in this study. The literature is screened and evaluated according to inclusion and exclusion criteria, and meta-analysis is performed using RevMan 5.3 software. A total of 13 RCTS are included, with a total of 24754 parturients. The meta-analysis shows the average blood loss (SMD = 0.10, 95% CI (−0.11, 0.32), P = 0.35 ), the time of the third stage of labor (SMD = 0, 95% CI (−0.07, 0.08), P = 0.95 ), and blood transfusion rate (RR = 0.80, 95% CI (0.63, 1.02), P = 0.07 ). However, the incidences of shivering (RR = 2.61, 95% CI (1.79, 0.81), P < 0.00001 ) and vomiting (RR = 2.78, 95% CI (1.85, 4.18), P < 0.00001 ) are significantly higher than those in oxytocin group. The effect of misoprostol on preventing postpartum hemorrhage is similar to that of oxytocin, but the incidence of adverse reactions is high, and the occurrence of adverse reactions should be closely watched in the use process. Due to the limitations of the included studies, multicenter, large-sample, and high-quality RCTS are still needed in the future to further verify this conclusion.

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Section: Introductionmentioning

confidence: 99%

Comparison of Clinical Efficacy and Safety between Misoprostol and Oxytocin in the Prevention of Postpartum Hemorrhage: A Meta-Analysis

Guo

Zhang

et al. 2022

Journal of Healthcare Engineering

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“…Thirty studies including 6593 women fulfilled our inclusion criteria (26 in English, 3,10,12,16,20–41 2 in Thai, 42,43 1 in each of the following languages French 44 and Chinese 45 ). Preoperative misoprostol was compared to postoperative misoprostol in four studies, 12,17,31,38 1 study compared misoprostol versus carbetocin, 41 another one compared misoprostol to ergometrine 40 and the rest 26 studies compared misoprostol to oxytocin.…”

Section: Resultsmentioning

confidence: 99%

“…2 The incidence of CD has increased in both high-and lowincome countries. 3 The World Health Organization (WHO) reported a large discrepancy among countries in the Eastern Mediterranean Region with very high CD rates in Egypt, Iran, and Lebanon (52%, 48%, and 46%, respectively) and a less than 5% rates in Somalia and Afghanistan. 4 This Eastern Mediterranean Region has a maternal mortality rate of 166/100 000 live births.…”

Section: Introductionmentioning

confidence: 99%

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The efficacy of misoprostol in reducing intraoperative blood loss in women undergoing elective cesarean section. A systematic review and meta‐analysis

Maged

Wali

Salah

2022

J of Obstet and Gynaecol

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Objectives To evaluate the efficacy of misoprostol to minimized blood loss during and after cesarean delivery (CD). Search Strategy Screening of MEDLINE, EMBASE, Web of Science, the Cochrane Central Register of Controlled Trials from inception to February 2021 using the keywords related to misoprostol, CD, postpartum hemorrhage, and intraoperative blood loss and their MeSH terms. Selection criteria Only RCTs were included. Participants included women undergoing CD whether elective or selective. Thirty studies including 6593 women, 26 in English, 2 in Thai, 1 in French, and 1 in Chinese. Data Collection and Analysis Data from all selected studies were extracted independently by two authors. Data extracted included location of the trial, sample size, inclusion and exclusion criteria, participants characteristics, intervention details including timing, dose, and route of drug administration. Outcomes assessed included estimated intraoperative and postoperative blood loss, occurrence of postpartum hemorrhage, the need for additional uterotonics, and hemoglobin difference. Main Results Four studies (968 women) compared preoperative to postoperative misoprostol and found a mean difference in intraoperative blood loss of −205.00 (−339.22, −70.77), p = 0.003 and in postoperative blood loss −216.27 (−347.08, −85.46), p < 0.001 and a significantly lower need for additional uterotonics with a risk ratio of 0.54 (0.46, 0.64), p < 0.00001. Twenty‐two studies (4701 participants) compared misoprostol to oxytocin. There was a mean difference in intraoperative blood loss of −108.43 (−156.04, −60.82), p < 0.0001. Nine of these trials with 1978 participants evaluated postoperative blood loss. These found a mean difference of −64.12 (−116.19, −12.04) with a p = 0.02. Fourteen trials with 3166 participants measured the difference between preoperative and postoperative hemoglobin. These found a mean difference of −0.25 (−0.35, −0.15) with a p < 0.001. Twenty trials with 4416 participants measured the need for administration of additional uterotonics. These found a risk ratio of 0.62 (0.49, 0.78) with a p value of <0.001. Conclusion The combined use of misoprostol and oxytocin during CD is effective in reducing blood loss during and after CD.

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“…In a study by Eftekhari on 100 pregnant women who underwent cesarean delivery under general anesthesia, one group received 200 μg of sublingual misoprostol and the second group received 20 units of oxytocin. The rate of blood loss in the misoprostol group was significantly lower compared to the oxytocin group [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

Prophylactic effect of rectal and sublingual misoprostol on postpartum hemorrhage in mothers with preeclampsia following cesarean section surgery; a double-blind randomized controlled trial

Afkham¹,

Hashemnejad

Saeieh

et al. 2022

Annals of Medicine &Amp; Surgery

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RETRACTED ARTICLE: Rectal vs. sublingual misoprostol before cesarean section: double-blind, three-arm, randomized clinical trial

Cited by 8 publications

References 21 publications

Comparison of Clinical Efficacy and Safety between Misoprostol and Oxytocin in the Prevention of Postpartum Hemorrhage: A Meta-Analysis

Comparison of Clinical Efficacy and Safety between Misoprostol and Oxytocin in the Prevention of Postpartum Hemorrhage: A Meta-Analysis

The efficacy of misoprostol in reducing intraoperative blood loss in women undergoing elective cesarean section. A systematic review and meta‐analysis

Prophylactic effect of rectal and sublingual misoprostol on postpartum hemorrhage in mothers with preeclampsia following cesarean section surgery; a double-blind randomized controlled trial

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