Severe hyperthermia following oral misoprostol in the immediate postpartum period

Chong, Yap Seng; Chua, S.; Arulkumaran, Sabaratnam

doi:10.1016/s0029-7844(97)00275-5

Cited by 44 publications

(44 citation statements)

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“…Life-threatening hyperpyrexia has been reported following the use of misoprostol, 800 µg orally, after childbirth. 22 Whenever a new medical intervention is promoted, one must take into account not only its clinical benefits and risks, but also the collateral benefits and risks from both use and potential misuse in the community. Before distributing misoprostol at the community level, it is important to consider its possible misuse, an example being its administration before delivery, which could lead to uterine rupture.…”

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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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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“…Однако ряд объединенных международных исследований показал, что они не имеют преимуществ перед традиционными утеротониками [24,25]. Между тем их применение сочетается с более высокой частотой побочных эффектов [24].…”

Section: ключевые слова: послеродовые кровотечения профилактика лечunclassified

International experience with pabal (carbetocin) for the prevention and treatment of postpartum hemorrhage

Shakurova¹,

Ivshin²,

Yatsukhno³

et al. 2016

Ross. vestn. akush.-ginekol.

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. ShakUrOVa, Cand. Med. Sci.; a.a. iVShiN, Cand. Med. Sci.; l.V. yaTSUkhNO; i.e. yakOVleVa; a.i. yakOVleVa; P.V. kOlyBiNa republican Perinatal Center, republic of karelia, Petrozavodsk, russiaThe given review paper briefly considers traditional medicamentous methods for the prevention and treatment of postpartum hemorrhage. Primary emphasis is placed on the use of the longacting oxytocin agonist carbetocin (pabal) to prevent postpar tum hemorrhage, after abdominal delivery in particular. analysis of published works has established that carbetocin combines the safety and tolerability of oxytocin and the stable uterotonic effect of ergometrine. at present, carbetocin (pabal) is primarily indicated for the prevention of uterine hypotonicity and atony during cesarean section. The single intravenous administration of 100 µg of carbetocin (pabal) versus placebo or intravenous oxytocin significantly reduces the need for additional uterotonics to maintain adequate uterine tone and to prevent/treat massive hemorrhage after cesarean section. The administration of this drug is noted to be associated with a lower rate of adverse effects. Carbetocin (pabal) has great economic advantages over ocytocin.The authors declare no conflicts of interest.

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“…Moreover, most uterotonics must be administered by injection; which requires sterile equipment and training in safe administration, prerequisites which are unavailable for most women delivering in poor undeveloped countries.Misoprostol, a prostaglandin E1 analog can be administered orally, rectally, or sublingually.Misoprostol offers distinct advantages because it is stable at room temperature, affordable, and easy to administer. Gastrointestinal symptoms (nausea, vomiting and diarrhea) and fever are the most common adverse effects of misoprostol, which often are mild and self-limited (5)(6)(7). Several studies have shown that misoprostol is more effective than oxytocin and methylergometrine in the treatment of PPH (8,9).…”

Section: Introductionmentioning

confidence: 99%

MISOP ROSTOL : AN ALTERNATIVE TO OXYTOCIN IN MANAGEMENT OF 3 rd STAGE OF LABOUR IN RURAL INDIA??

yadav¹,

gaur²,

meena³

2017

Int J Recent Sci Res

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ARTICLE INFO ABSTRACTBackground: Postpartum haemorrhage is a life-threatening obstetricemergency that occurs after normal vaginal delivery or caesarean section. Prevention of PPH can be achieved by active management of the third stage of labour in most of the cases. Various uterotonic agents play major role in prevention of PPH. Objective: To compare efficacy of oxytocin 10 IU intramuscular and misoprostol 800µg per rectally in active management of the third stage of labor and determine duration of the third stage of labor, blood loss, effect on haemoglobin of the patient, adverse effects and need for additional uterotonics in both group. Study methods: A prospective observational study was carried out in the Department of Obstetrics and Gynaecology, Kanwatiya Hospital, SMS Medical College, Jaipur(Rajasthan) from December 2016 to February 2017. Active management of 3rd stage of labor was done by using either inj. Oxytocin 10 IU or tab. Misoprostol 800µg as per the group of the patient. Duration of the third stage of labor,the amount of blood loss, the incidenceof postpartum haemorrhage, a drop in haemoglobinconcentration from predelivery to 24 h after delivery and adverse effect of drugs were measured. Results: Demographic characteristics were similar in each treatmentgroup. There was no significant difference between treatment groups in decrease in hemoglobin (oxytocin 0.7 g/dL, misoprostol 0.8 g/dL). Duration of 3 rd stage of labor was slight more with misoprostol group.The significant side effect was shivering and fever, which were more common in the misoprostol group (shiveringmisoprostol 14% vs. oxytocin 5% and (fever -misoprostol 6% vs. oxytocin 1%). Conclusion: Rectal misoprostol 800µg is as effective as 10 IU intramuscular oxytocin in minimizing blood loss in the third stage of labour. Rectal misoprostol has a lower incidence of side effects which are self limiting. This supports the utility of misoprostol as a safe and effective uterotonic for use in the rural and remote areas of developing countries where other pharmacologic agents may be less feasible.

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Severe hyperthermia following oral misoprostol in the immediate postpartum period

Cited by 44 publications

References 4 publications

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

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

International experience with pabal (carbetocin) for the prevention and treatment of postpartum hemorrhage

MISOP ROSTOL : AN ALTERNATIVE TO OXYTOCIN IN MANAGEMENT OF 3 rd STAGE OF LABOUR IN RURAL INDIA??

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