I237 Treatment of postpartum hemorrhage with sublingual misoprostol versus oxytocin: Results from a randomized, non‐inferiority trial among women not exposed to oxytocin during labor

Winikoff, Beverly; Dabash, Rasha; Durocher, Jill; Darwish, Emad; Ngoc, Nguyen Thi Nhu; León, Wilfredo; Raghavan, Sheila; Medhat, I.; Barrera, Gustavo; Blum, Jennifer

doi:10.1016/s0020-7292(09)60237-x

Cited by 6 publications

(3 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The studies recruited a total of 40 000 women from a range of units throughout the world, some of which routinely gave oxytocin for prophylaxis, and some that gave no prophylaxis. 23,24 The women who developed PPH were randomized to receive a high-dose oxytocin infusion (40 iu over 15 minutes) or misoprostol (800 μg, sublingually), each with placebos so as to ensure double blinding. In the units where there was no oxytocin prophylaxis there was less additional blood loss in those given oxytocins than for those given misoprostol.…”

Section: Discussionmentioning

confidence: 99%

Adjunctive sublingual misoprostol for secondary prevention of post-partum hemorrhage during cesarean delivery: double blind placebo randomized controlled trial

Sallam

Shady

2018

Int J Reprod Contracept Obstet Gynecol

View full text Add to dashboard Cite

Background: Cesarean delivery is the most frequently performed major operative procedure worldwide. Objective of present study was to evaluate randomized evidence regarding efficacy and safety of sublingual misoprostol for secondary prevention of post-partum hemorrhage during and after cesarean delivery in women receiving prophylactic oxytocin as primary preventive tools and bleed around 500ml by visual analogue estimation.Methods: A prospective, randomized, double-blind, placebo-controlled trial was performed at an obstetrics and gynecology department Aswan university hospital, Egypt, between October 2015 and September 2017. Women were eligible if they were undergoing elective cesarean under spinal anesthesia and were bleed around 500ml by visual analogue estimation. All participants received 10 IU oxytocin after delivery of the newborn. Participants were randomly assigned (1:1) to receive 400 μg misoprostol or matched placebo sublingually using a computer-generated random number sequence. Participants and providers were masked to assignment. The primary outcomes were intraoperative and postoperative blood loss.Results: There was high significant reduction in intraoperative blood loss in misoprostol group (711.0±188.41) compared with placebo group (915.33±293.72) (P=0.0001). The all estimated blood loss during CS and 24 hours postoperative was significant lower in misoprostol group (890.39±194.49) than that in placebo group (1096.9±300.05) (p=0.0001).Conclusions: Misoprostol as an adjunct to oxytocin as secondary prevention of pot partum hemorrhage seemed to be more effectively reduce blood loss than did placebo with oxytocin alone.

show abstract

Section: Discussionmentioning

confidence: 99%

Adjunctive sublingual misoprostol for secondary prevention of post-partum hemorrhage during cesarean delivery: double blind placebo randomized controlled trial

Sallam

Shady

2018

Int J Reprod Contracept Obstet Gynecol

View full text Add to dashboard Cite

show abstract

“…The studies recruited a total of 40 000 women from a range of units throughout the world, some of which routinely gave oxytocin for prophylaxis, 39 and some that gave no prophylaxis. 40 The women who developed PPH were randomised to receive a high-dose oxytocin infusion (40 iu over 15 minutes) or misoprostol (800 lg, sublingually), each with placebos so as to ensure double blinding. In the units where there was no oxytocin prophylaxis there was less additional blood loss in those given oxytocin than for those given misoprostol.…”

Section: Misoprostolmentioning

confidence: 99%

The prevention and treatment of postpartum haemorrhage: what do we know, and where do we go to next?

Weeks

2014

BJOG

154

129

View full text Add to dashboard Cite

Postpartum haemorrhage (PPH) remains a major cause of maternal deaths worldwide, and is estimated to cause the death of a woman every 10 minutes. This review presents the latest clinical advice, including new evidence on controlled cord traction, misoprostol, and oxytocin. The controversy around the diagnosis of PPH, the limitations of universal prophylaxis, and novel ways to provide obstetric first aid are also presented. It ends with a call to develop high-quality front-line obstetric services that can deal rapidly with unexpected haemorrhages as well as minimising blood loss at critical times: major abruption, placenta praevia, and caesarean for prolonged labour.

show abstract

“…These bleeds were experienced by just eight of 9348 women (0.09%) who had a vaginal birth without oxytocin prophylaxis, 13 and 14 of 31 055 of those (0.05%) who did receive prophylaxis. 14 This compares to rates of around 0.5-1% for postpartum bleeds of 2000-2500 mL with prophylaxis in high resource populations (table⇓).…”

Section: Analysis Evidence Based On Uncomplicated Birthsmentioning

confidence: 99%

Rethinking our approach to postpartum haemorrhage and uterotonics

Weeks

Neilson

2015

BMJ

View full text Add to dashboard Cite

show abstract

I237 Treatment of postpartum hemorrhage with sublingual misoprostol versus oxytocin: Results from a randomized, non‐inferiority trial among women not exposed to oxytocin during labor

Cited by 6 publications

References 0 publications

Adjunctive sublingual misoprostol for secondary prevention of post-partum hemorrhage during cesarean delivery: double blind placebo randomized controlled trial

Adjunctive sublingual misoprostol for secondary prevention of post-partum hemorrhage during cesarean delivery: double blind placebo randomized controlled trial

The prevention and treatment of postpartum haemorrhage: what do we know, and where do we go to next?

Rethinking our approach to postpartum haemorrhage and uterotonics

Contact Info

Product

Resources

About