Different routes and forms of uterotonics for treatment of retained placenta: a randomized clinical trial*

Maher, Mohamed; Sayyed, Tarek; Elkhouly, Nabih I

doi:10.1080/14767058.2016.1242124

Cited by 19 publications

(24 citation statements)

References 16 publications

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“…1). Seven studies met the inclusion criteria [12][13][14][15][16][17][18] ; nine trials were excluded because they were not randomized controlled trials (n=6), were not original articles (n=2), or were a preliminary report (n=1). The included studies are described in Table S1.…”

Section: Resultsmentioning

confidence: 99%

“…In all studies, the outcomes had a high risk of bias according to the Cochrane Risk of Bias Domains (Table S3). For the random sequence generation domain, only four trials [12][13][14][15] appropriately reported the method used and were assessed as low risk of bias. For allocation concealment, five trials [14][15][16][17][18] adequately implemented a valid concealment of allocation method by using sequentially numbered sealed envelopes or containers with a similar appearance, making selection bias at enrollment unlikely.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Systematic review of prostaglandin analogues for retained placenta

Grillo‐Ardila

Amaya-Guío

Ruíz-Parra

et al. 2018

Intl J Gynecology & Obste

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Section: Resultsmentioning

confidence: 99%

mentioning

confidence: 99%

Systematic review of prostaglandin analogues for retained placenta

Grillo‐Ardila

Amaya-Guío

Ruíz-Parra

et al. 2018

Intl J Gynecology & Obste

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“…By contrast, the authors of another study reported that carbetocin had the same effectiveness as oxytocin at lower doses and needed less time to be effective. Conversely, misoprostol needed the longest period to reach sufficient uterine contractility [17]. No differences in effectiveness were reported for an intravenous administration of 100 μg of carbetocin and 5 IU of oxytocin [18].…”

Section: Preventionmentioning

confidence: 96%

“…Obviously, pharmacologic treatment should be introduced simultaneously -intravenous 10-30 IU of oxytocin or 100 µg of intravenous bolus of carbetocin, with similar clinical effectiveness (blood loss, severe postpartum hemorrhage, blood products transfusions). On the other hand few studies has shown higher effectiveness (amount of blood loss and the need for other uterotonics) of 100 µg carbetocin vs 5 IU oxytocin in EPH management [17].…”

Section: Treatmentmentioning

confidence: 99%

Epidemiology, prevention and management of early postpartum hemorrhage — a systematic review

et al. 2020

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Early Postpartum Hemorrhage (EPH) is one of the leading causes of postpartum mortality. It is defined as blood loss of at least 500 mL after vaginal or 1000 mL following cesarean delivery within 24 hours postpartum. The following paper includes literature review aimed to estimate the incidence and predictors of early postpartum hemorrhage (EPH). Available prevention and treatment methods were also assessed. The inclusion criteria for the study were met by 52 studies.The exact frequency of EPH in different populations varies from 1.2% to 12.5%. Maternal, pregnancy-associated, laborcorrelated and sociodemographic risk factors seem to be important predictors of EPH. In these cases appropriate prophylaxis should be considered. However, EPH may occur without previous risk factors. The main reason for EPH is uterine atony which contributes to up to 80% of cases of postpartum hemorrhage (PPH). Other common reasons for PPH include genital tract injuries, placenta accreta or coagulopathies. Interestingly, the majority of uterotonics seem to have a similar effect. However, carbetocin seems to be the most effective in certain situations.Appropriate diagnosis of EPH is the most important issue. The treatment should be causative. The first-line treatment should include uterotonics. Surgical interventions, if required, should be performed without delay, although preoperative uterine tamponade should be considered due to its high effectiveness.Medical staff training in medical simulation centers is an important factor that improves the outcomes of EPH treatment. It provides adaptation to hospital protocols, team work improvement, self-confidence building, more accurate blood loss evaluation and reduced perception of stress. The implementation of systematic trainings provides better outcomes in the future.

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“…[11][12][13] Also, in cases with retained placenta it may have a role in management of associated bleeding which mostly result from atony. 14,15 In the field of gynecology, misoprostol could be used for induction of cervical ripening before office gynecological procedures. [16][17][18] This could decrease the associated pain induced by transcervical passage of instruments.…”

Section: Introductionmentioning

confidence: 99%

Intrauterine Misoprostol versus intravenous Oxytocin infusion during cesarean delivery to reduce intraoperative and postoperative blood loss: a randomised clinical trial

Abdelaleem

Abdelaleem²,

Abbas

2019

Int J Reprod Contracept Obstet Gynecol

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Background: The objective of the present study was to compare the efficacy of intrauterine misoprostol with intravenous oxytocin infusion in reducing blood loss during and after cesarean section (CS).Methods: An open, randomized, clinical trial, registered (ClinicalTrials.gov ID: NCT03148574) conducted between July 1, 2017 and April 1, 2018. The study included 240 pregnant females that were recruited at term (37-40 weeks) gestation scheduled for either elective or emergency CS. Eligible participants were randomly allocated into two equal groups: Group A: patients who receive intravenous infusion of 10 I.U diluted to 500ml of normal saline for 30 minute after delivery. Group B: patients received 400μg misoprostol intrauterine just after cord clamping and delivery of the placenta. Primary outcome measure was assessment of amount of intraoperative and postoperative blood loss.Results: The intraoperative and 2h postoperative blood loss in the misoprostol group was higher than oxytocin group (p<0.001). Hemoglobin level decreased significantly among both groups, manifested by the highly significant p value in comparison of pre and postoperative Hb level in the two groups (p<0.001). However, the blood loss in the misoprostol group was higher than oxytocin group (p=0.004). There was a statistical significant differences between both groups as regards the need for additional uterotonic drug (66% in misoprostol group vs 5% in oxytocin group, P<0.001). Shivering and pyrexia were more in common in the misoprostol group while vomiting, headache and giddiness were significantly higher among oxytocin group.Conclusions: Administration of misoprostol 400mcg through intrauterine route appears to be less effective than intravenous oxytocin infusion in reducing blood loss during and after CS.

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Different routes and forms of uterotonics for treatment of retained placenta: a randomized clinical trial*

Cited by 19 publications

References 16 publications

Systematic review of prostaglandin analogues for retained placenta

Systematic review of prostaglandin analogues for retained placenta

Epidemiology, prevention and management of early postpartum hemorrhage — a systematic review

Intrauterine Misoprostol versus intravenous Oxytocin infusion during cesarean delivery to reduce intraoperative and postoperative blood loss: a randomised clinical trial

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