Prostaglandins for preventing postpartum haemorrhage

Tunçalp, Özge; Hofmeyr, G Justus; Gülmezoglu, A. Metin

doi:10.1002/14651858.cd000494.pub4

Cited by 132 publications

(120 citation statements)

References 106 publications

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“…17 Studies have shown that Misoprostol is not as effective as Oxytocin for the prevention of PPH and that maternal pyrexia is a significant adverse effect. 14,16,[18][19][20] However, misoprostol is a suitable agent for management of the third stage of labour when other agents are not available for reasons of cost, storage, or difficulty of administration. 18,21,22. Though blood loss in group C was comparatively higher, there were no values found more than 200 ml.…”

Section: Discussionmentioning

confidence: 99%

A comparative study of efficacy of oxytocin, methylergometrine and misoprostol in prevention of post-partum haemorrhage

Alam

Shyam

Goswami

2017

Int J Reprod Contracept Obstet Gynecol

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Background: To compare the efficacy of oxytocin, methylergometrine and misoprostol in active management of third stage of labour (AMTSL).Methods: A clinical study was conducted on 330 low risk pregnant women with a healthy singleton pregnancy and spontaneous onset of labour at term; allocated into three groups where active management of third stage of labour was done with either Oxytocin 10 IU intramuscular, or Methylergometrine 0.2 mg intramuscular, or tab Misoprostol 600µg sublingual on 110 women each group. Primary parameter was blood loss during labour. Secondary parameters were the duration of third stage of labour and changes in haemoglobin level.Results: Blood loss during labour in Oxytocin group was 145.86±11.53 ml, which was significantly less than that in Methylergometrine (164.02±9.36 ml) and Misoprostol groups (183.18±9.70 ml), but no patient in any of the groups had blood loss more than 200ml. Duration of third stage of labour was significantly less in Oxytocin group (5.13±1.91 mins) than in. Methylergometrine (6.16±1.85 mins), and Misoprostol groups (6.47±1.51 mins). No patient had prolonged third stage in any of the groups. There was no significant change in pre-and post-delivery haemoglobin levels in all the groups.Conclusions: Though injectable uterotonics are effective for active management of third stage of labour (AMTSL), misoprostol can also be effectively used, especially in settings where there is no adequate trained personnel and drug storage facility.

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Section: Discussionmentioning

confidence: 99%

A comparative study of efficacy of oxytocin, methylergometrine and misoprostol in prevention of post-partum haemorrhage

Alam

Shyam

Goswami

2017

Int J Reprod Contracept Obstet Gynecol

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“…However, conflicting results showing that misoprostol is less effective than traditional uterotonics have also been published [8]. A recent Cochrane meta-analysis concluded that misoprostol is better than a placebo but less effective than conventional parenteral oxytocics during active management of third stage of labor [9].…”

Section: Discussionmentioning

confidence: 99%

A Comparative Study of Oxytocin/Misoprostol/Methylergometrine for Active Management of the Third Stage of Labor

Sharma¹,

Kaur²,

Kaur³

et al. 2014

J Obstet Gynecol India

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Objectives To study oxytocin, misoprostol, and methylergometrine in active management of the third stage of labor and determine duration of the third stage of labor, blood loss, adverse effects, and need for additional uterotonics in each group. Methods Clinical trial of 300 women with healthy singleton pregnancy allocated into three groups to receive either: 10 IU intravenous oxytocin infusion, 600 lg sublingual misoprostol, or 200 lg intravenous methylergometrine. Primary outcome measure was blood loss in the third stage of labor; secondary measures were duration of the third stage, side effects, and complications. Results Subjects who received 600 lg of misoprostol had the least blood loss, followed by oxytocin, and methylergometrine. The shortest mean duration of the third stage was with misoprostol. Shivering and pyrexia were observed in misoprostol group, and raised blood pressure in methylergometrine group. Conclusions Misoprostol is as effective as oxytocin and both are more effective than methylergometrine in active management of the third stage of labor.

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“…These agents are of similar efficacy to oxytocin and therefore would be expected by inference to have superior efficacy to misoprostol. [2] Ergometrine has a longer duration of action than oxytocin. [3] Oxytocin A key step in avoiding postpartum haemorrhage (PPH) is ensuring adequate uterine contraction, as this serves to control bleeding from the placental bed naturally.…”

Section: Specific Problems With Uterotonicsmentioning

confidence: 99%

“…However, concerning data have been published about adverse effects and worsening outcomes at higher doses. [2] While side-effects of pyrexia and tachycardia are well documented, misoprostol may be a useful adjunct when used in appropriate doses. Since many patients will have received prior doses of misoprostol, it is important to check carefully on the total dose already administered; sufficient drug should be given to bring the total dose up to 600 mg. Anaesthetists find that misoprostol is often most conveniently administered sublingually.…”

Section: Ergometrinementioning

confidence: 99%