A randomized controlled trial of sublingual misoprostol and intramuscular oxytocin for prevention of postpartum hemorrhage

Abstract

Sublingual misoprostol is as effective as intramuscular oxytocin as a prophylactic oxytocic in the active management of third stage of labor for prevention of postpartum hemorrhage.

A Comparison of the Effectiveness of Sublingual Misoprostol Versus Intravenous Oxytocin Infusion in Reducing Blood Loss in First Two Hours at Caesarean Section

“…Priya in her study reported that two cases in misoprostol group and three cases in oxytocin group required additional oxytocin because of uterine atony. 22 Chaudhuri et al, in his study reported no statistical significance in the requirement of additional oxytocin in between the two groups in both the studies. 21 In Bellad et al study, one case in misoprostol group required additional oxytocin whereas 8 cases in oxytocin group which was statistically significant (p=0.002).…”

Factors affecting the prevention of postpartum hemorrhage in Low- and Middle-Income Countries: A scoping review of the literature

“…[30,38] Results from this scoping review also demonstrate the possibility and benefits of distribution of misoprostol to clients either for auto-administration, or administration by community health care professionals, auxiliary midwives or community health workers. [33,34,36,38,39,44,47,53,54] A study conducted in Rwanda [34] to investigate the coverage, acceptability, and feasibility of a program for PPH prevention at community and health facility level found that administration of misoprostol by CHWs at the time of delivery for home births achieved reasonable uterotonic coverage. On the other hand, the program achieved satisfactory uterotonic coverage of 82.5% for all deliveries at the level of health facility due primarily to routine and proper management of the third stage of labor for a high proportion of facility-based deliveries.…”

Postpartum haemorrhage (PPH) rates in randomized trials of PPH prophylactic interventions and the effect of underlying participant PPH risk: a meta-analysis

“…The risk of bias was assessed independently by LH and AW for 14 trials [10][11][12][13][14][15][16][17][18][19][20][21][22][23]. Six assessments [24][25][26][27][28][29] were produced during a review by Gallos et al [30].…”

“…Four trials were considered to have an unclear risk of selection bias as the methods to describe adequate random sequence generation were not reported or inadequately described [14,15,28,42]. There was an unclear risk for five trials [19,28,29,35,39] concerning allocation concealment as it was not reported appropriately. The Diop 2016 [11] and Raghavan 2015 [21] trials were cluster randomised trials meaning allocation would have been known in advance so were judged to be high risk for inadequate allocation concealment.…”

“…Detection bias showed similar results with 50% of trials deemed low risk, 17% unclear and 33% high risk. The large number of trials judged to be unclear or high risk for performance and detection bias were commonly due to difficult blinding participants and personnel to interventions due to the differences in administration [11,16,19,21,22,31,32,35,39,41,42,44], unclear reporting of methods [28,29] and a likelihood that blinding could be broken [18,20]. The Deneux-Tharaux 2013 [32] and Groot 1996 [44] trials were judged to be high risk of performance bias but low and unclear risk of detection bias, respectively, due to the use of objective measurements for the primary outcome.…”