Rectal Misoprostol Versus Oxytocin in the Management of the Third Stage of Labour

Parsons, Steven M.; Walley, Robert L.; Crane, Joan; Matthews, Kay; Hutchens, Donna

doi:10.1016/s1701-2163(16)32594-4

Cited by 27 publications

(23 citation statements)

References 33 publications

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“…However, Aghazadeh Naini (2014) detected no difference in side effects between the 2 groups (19). Our study showed no significant differences between drug side effects such as fever, uterine tonus, and nausea in the 2 groups, but shivering in misoprostol group was significantly higher than the other group, and this finding has also been reported previously (4,7,(20)(21)(22)(23)(24). In Chaudhuri et al (2010) study, in patients that received misoprostol, shivering was a common side effect (4) although 800 µg rectal misoprostol had lower shivering (8.33%) than our study (39.6%), which can be related to its pharmacokinetic effect in rectal administration versus sublingual (25).…”

Section: Beigi Et Al (2009) In a Clinical Trial On 542 Nulliparous Wsupporting

confidence: 89%

Comparison of Sublingual Misoprostol and Intravenous Oxytocin in the Management of Postpartum Hemorrhage After Cesarean Delivery: A Randomized Controlled Trial

Rahbar

Mirjan

Ghorbani

2018

Middle East J Rehabil Health Stud

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Section: Beigi Et Al (2009) In a Clinical Trial On 542 Nulliparous Wsupporting

confidence: 89%

Comparison of Sublingual Misoprostol and Intravenous Oxytocin in the Management of Postpartum Hemorrhage After Cesarean Delivery: A Randomized Controlled Trial

Rahbar

Mirjan

Ghorbani

2018

Middle East J Rehabil Health Stud

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“…blood loss of 500 ml) and found that ergometrine-oxytocin was associated with small reduction in the risk of PPH (odds ratio = 0.82) but more of nausea, vomiting and hypertension. Parson et al [11] compared rectal misoprostol 800 lg versus oxytocin 10 IU intramuscular with delivery of anterior shoulder. The results were compared in terms of change in haemoglobin concentration before and after delivery, need of additional oxytocics, estimated blood loss, transfusion and medication side-effects.…”

Section: Resultsmentioning

confidence: 99%

A Study to Compare the Efficacy of Misoprostol, Oxytocin, Methyl-ergometrine and Ergometrine–Oxytocin in Reducing Blood Loss in Active Management of 3rd Stage of Labor

Gohil

Tripathi

2011

J Obstet Gynecol India

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Objectives The purpose of the study was to compare the efficacy of misoprostol 400 lg per rectally, injection oxytocin 10 IU intramuscular, injection methylergometrine 0.2 mg intravenously and injection (0.5 mg ergometrine ? 5 IU oxytocin) intramuscular on reducing blood loss in third stage of labor, duration of third stage of labor, effect on haemoglobin of the patient, need of additional oxytocics or blood transfusion and associated side effects and complications. Study Design A prospective non-randomized uncontrolled study was carried out in the Department of Obstetrics and Gynecology, SSG Hospital and Medical College, Baroda enrolling 200 women and dividing them into four groups. Active management of 3rd stage of labor was done using one of the 4 uterotonics as per the group of the patient. The main outcome measures were the amount of blood loss, the incidence of postpartum hemorrhage and a drop in hemoglobin concentration from before delivery to 24 h after delivery. Results Methylergometrine was found to be superior to rest of the drugs in the study with lowest duration of third stage of labor (P = 0.000096), lowest amount of blood loss (P = 0.000017) and lowest incidence of PPH (P = 0.03). There was no significant difference in the pre-delivery and the post-delivery hemoglobin concentration amongst the four groups with P = 0.061. The need of additional oxytocics and blood transfusion was highest with misoprostol as compared to all other drugs used in the study with P = 0.037 and 0.009, respectively. As regards side effects, misoprostol was associated with shivering and pyrexia in significantly high number of patients as compared to the other drugs used in the study while nausea, vomiting and headache were more associated with methylergometrine and ergometrine-oxytocin. However all the side effects were acceptable and preferable to the excessive blood loss. Conclusion Methylergometrine has the best uterotonic drug profile amongst the drugs used, strongly favouring its routine use as oxytocic for active management of third stage of labor. Misoprostol was found to cause a higher blood loss compared to other drugs and hence should be used only in low resource setting where other drugs are not available. The role of misoprostol in third stage of labor needs larger studies to be proved.Keywords Uterotonics Á 3rd stage of labor Á Post-partum hemorrhage Á Brass-V drapes

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“…Furthermore, 400 μg of misoprostol administered orally has been compared with intravenous or intramuscular oxytocin in smaller hospital-based randomized controlled trials [3,7]. In addition, 800 μg of rectal misoprostol has also been evaluated for PPH prophylaxis [9,10]. Although promising results have been obtained in almost all studies, a Cochrane review concluded that there is no consensus regarding the optimal route and dose of misoprostol [11].…”

Section: Discussionmentioning

confidence: 99%

“…It is well absorbed when administered by oral, vaginal, sublingual, rectal, and buccal routes. Oral [3][4][5][6][7][8] and rectal [9,10] administration of misoprostol has been found to be effective in preventing and controlling PPH in various studies. Although misoprostol has been included recently in the WHO essential medicine list, the lowest effective dose and the optimal route of administration for maximum benefit and minimum adverse effects is yet to be established [11,12].…”

Section: Introductionmentioning

confidence: 99%

Sublingual misoprostol versus intramuscular oxytocin for prevention of postpartum hemorrhage in low-risk women

Chaudhuri¹,

Biswas²,

Mandal³

2011

International Journal of Gynecology & Obstetrics

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Rectal Misoprostol Versus Oxytocin in the Management of the Third Stage of Labour

Cited by 27 publications

References 33 publications

Comparison of Sublingual Misoprostol and Intravenous Oxytocin in the Management of Postpartum Hemorrhage After Cesarean Delivery: A Randomized Controlled Trial

Comparison of Sublingual Misoprostol and Intravenous Oxytocin in the Management of Postpartum Hemorrhage After Cesarean Delivery: A Randomized Controlled Trial

A Study to Compare the Efficacy of Misoprostol, Oxytocin, Methyl-ergometrine and Ergometrine–Oxytocin in Reducing Blood Loss in Active Management of 3rd Stage of Labor

Sublingual misoprostol versus intramuscular oxytocin for prevention of postpartum hemorrhage in low-risk women

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