Comparing and combining evidence of treatment effects in randomized and nonrandomized studies on the use of misoprostol to prevent postpartum hemorrhage

Morfaw, Frederick; Miregwa, Bernard; Ayaba, Bi; Mbuagbaw, Lawrence; Anderson, Laura N.; Thabane, Lehana

doi:10.1111/jebm.12440

Cited by 6 publications

(2 citation statements)

References 63 publications

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“…According to WHO, PPH is the leading cause of maternal morbidity and mortality (Morfaw et al, 2021). Mean blood loss is highest in emergency hysterectomy (3500 mL), followed by cesarean section (1000 mL) and vaginal delivery (500 mL of blood) (Koch and Rattmann, 2019).…”

Section: Discussionmentioning

confidence: 99%

Comparison of Sublingual Misoprostol Versus Intravenous Oxytocin for Reducing Mean Blood Loss After Vaginal Delivery

KHAN

PARVEEN

SADIQ

et al. 2022

Biol Clin Sci Res J

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Postpartum hemorrhage (PPH) is significantly associated with maternal morbidity and mortality, and many maternal deaths are preventable. Uterine atony is managed through uterotonic agents like prostaglandin F2 alpha (PGF2a), misoprostol, ergometrine and oxytocin and uterine rubbing. This prospective study was designed to compare the role of sublingual misoprostol and IV oxytocin in preventing blood loss after vaginal deliveries. This study was conducted at the Department of Obstetrics & Gynecology, Nishtar Hospital Multan, from 15 February 2021 to 14 August 2021. The study was conducted on 60 patients, 30 in both groups, who were selected through consecutive nonprobability sampling. Subjects were divided into Group A and Group B. 600 µg misoprostol (3 doses of 200 µg) was administered to Group A. 5 IU oxytocin was administered to Group B, with 3.3 IU/min at the beginning with the interval of 20 minutes until regular contractions are achieved. A maximum of 30mU/min oxytocin was infused. Mean blood loss was measured and recorded in proforma. The mean age of the subjects was 29.21 ± 6.07 years. The mean age of Group A was 29.40 ± 5.85 years, while that of Group B was 29.21 ± 6.32 years. Mean PPH blood loss in Group A, and B was 118.97 ± 20.26 ml and 154.13 ± 15.21 ml (P = 0.0001). The mean postpartum blood loss was higher by intravenous oxytocin than by sublingual misoprostol.

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Section: Discussionmentioning

confidence: 99%

Comparison of Sublingual Misoprostol Versus Intravenous Oxytocin for Reducing Mean Blood Loss After Vaginal Delivery

KHAN

PARVEEN

SADIQ

et al. 2022

Biol Clin Sci Res J

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“…The second line uterotonic agents including carboprost tromethamine, methylergonovine and misoprostol, which have been proved to be effective in preventing the occurrence of PPH, [37][38][39] are selected according to the adverse drug reactions and the complications of women. Carboprost tromethamine, a synthetic analog of prostaglandin F2α, is related to the stimulation of smooth muscles and prostaglandin-like side-effects, such as nausea, vomiting, fever, diarrhea, headaches, and elevated blood pressure.…”

Section: Interpretation Of the Ndingsmentioning

confidence: 99%

Relationship between intertwin delivery interval and postpartum hemorrhage in cesarean section: a seven-year retrospective cohort study

Lan,

Pan,

Zhou

et al. 2023

Preprint

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Background: Intertwin delivery interval (ITDI) is defined as the interval time between the delivery of the first and the second twin and may be controlled by obstetricians during cesarean deliveries. Several studies have demonstrated the relationship between ITDI and the adverse neonatal outcomes during vaginal births. However, few studies have explored the relationship between ITDI and maternal outcomes in cesarean deliveries. We hypothesized that ITDI may influence the occurrence and the development of postpartum hemorrhage by affecting uterine contraction. The purpose of this study was to investigate the relationship between ITDI and postpartum hemorrhage, and between ITDI and the maternal adverse outcomes that related to the blood loss in women with twin pregnancies delivered by cesarean section. Methods: A retrospective cohort of 1649 pregnant women with diamniotic twins was recruited from 2016 to 2022. They were categorized into the short ITDI group (0 min < ITDI ≤ 3 min), the medium ITDI group (3 min < ITDI ≤ 6 min) and the long ITDI group (6 min < ITDI ≤ 9 min) according to the range of ITDI of the eligible individuals (0-9 min). The primary outcome including PPH and the secondary outcomes including uterotonic administration, emergency operation, severe maternal morbidity and total blood loss ≥ 1500 ml were compared among the groups, and the relationship between ITDI and these outcomes was explored. Results: Little differences were found in the rates of postpartum hemorrhage, emergency operation, severe maternal morbidity and total blood loss ≥1500 ml among the three groups (P > 0.05). No relationship was found between ITDI and postpartum hemorrhage (P > 0.05). Women with long ITDI were at a decreased risk of uterotonic administration (adjusted OR = 0.369, 95% CI = 0.228-0.597, P < 0.001). Conclusions: Although the long ITDI did not reduce the incidence of postpartum hemorrhage during the cesarean delivery, the uterotonic administration was decreased though appropriately prolonged ITDI.

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Healthcare outcomes assessed with observational study designs compared with those assessed in randomized trials: a meta-epidemiological study

Toews,

Anglemyer,

Nyirenda

et al. 2024

Cochrane Database of Systematic Reviews

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Comparing and combining evidence of treatment effects in randomized and nonrandomized studies on the use of misoprostol to prevent postpartum hemorrhage

Cited by 6 publications

References 63 publications

Comparison of Sublingual Misoprostol Versus Intravenous Oxytocin for Reducing Mean Blood Loss After Vaginal Delivery

Comparison of Sublingual Misoprostol Versus Intravenous Oxytocin for Reducing Mean Blood Loss After Vaginal Delivery

Relationship between intertwin delivery interval and postpartum hemorrhage in cesarean section: a seven-year retrospective cohort study

Healthcare outcomes assessed with observational study designs compared with those assessed in randomized trials: a meta-epidemiological study

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