Risk of Fever After Misoprostol for the Prevention of Postpartum Hemorrhage

Elati, A; Weeks, Andrew

doi:10.1097/aog.0b013e3182707341

Cited by 28 publications

(17 citation statements)

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“…7,911,14 The reason behind it is due to the main action of Misoprostol in central thermoregulatory centre. 15 Another common side effect was per vaginal bleeding in the Misoprostol group which is similar to a study conducted by Montensionus et al 8 where the bleeding was encountered in 22.6% patients in the misoprostol group in compared to only 6.7% in MVA group. MVA was identified as more painful than misoprostol (24; 80%), which is in agreement with a study done by Shwekerela et al 7 and Bique et al 11 but in contrast to Niinimaki et al 16 Diarrhea was found significantly high in Misoprostol than MVA group which was a similar finding in a study done by Pang et al 17 In contrast, Phuong et al showed a low incidence of diarrhea in a single-dose regimen of misoprostol.…”

Section: Discussionsupporting

confidence: 83%

Comparison of Use of Misoprostol versus Manual Vacuum Aspiration in the Treatment of Incomplete Abortion

Khaniya¹,

Yadav

2019

Nep. Med. J.

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Introduction: Early pregnancy failure is a major health problem throughout the world. Expulsion of some but not all products of conception before 20 weeks of pregnancy abortion is incomplete abortion. This study was to find about the safety, efficacy, and acceptability of misoprostol in comparison to manual vacuum aspiration for the treatment of incomplete abortion so the safe and convenient method can be used in diverse settings in different parts of our country.Materials and Methods: A prospective comparative interventional study carried out between October 2011 to March 2012 AD (Kartik 2068 to Chaitra 2068 BS) in Paropakar Maternity and Women’s Hospital, Thapathali. All eligible women with a diagnosis of incomplete abortion of < 13 weeks of gestation either from LMP or Ultrasound were divided into two groups. Group 1 includes all odd numbers of cases under study group to whom 600 mcg Misoprostol was given orally. Group 2 includes all even the number of cases under study group to whom manual vacuum aspiration was done.Results: Out of 60 women enrolled in the study, 30 were enrolled in Group 1(Misoprostol P.O.) and 30 in Group 2 (manual vacuum aspiration). The study showed no significant difference in the efficacy of the Misoprostol as compared to manual vacuum aspiration (93.33% vs. 100%).Conclusions: The efficacy of oral Misoprostol is as effective as manual vacuum aspiration in the treatment of first trimester incomplete abortion with comparable success rate.

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Section: Discussionsupporting

confidence: 83%

Comparison of Use of Misoprostol versus Manual Vacuum Aspiration in the Treatment of Incomplete Abortion

Khaniya¹,

Yadav

2019

Nep. Med. J.

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“…28 The frequency of this side effect is related to dosage and route, with the highest rates of fever occurring with the sublingual route. 29 Genetic factors may account for the observed marked geographical differences in rates.…”

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

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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.

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“…Questions remain about who will develop high fever, but evidence shows that shivering and fever follow a predictable pattern [18,22,41]. A febrile response, triggered by misoprostol, is understood to occur when misoprostol crosses the blood–brain barrier and increases the thermoregulatory set point [18,21,23]. Shivering and increased heart rate are mechanisms that help to elevate the body’s temperature to this new set point [21].…”

Section: Discussionmentioning

confidence: 99%

“…Because of Ecuador’s exceptionally high rate of high fever, a genetic pre‐disposition was hypothesised [12,18,21,22] and later confirmed [23], showing a positive association between two prostaglandin transporter genes and misoprostol‐induced fever among Ecuadorian women who received PPH treatment with misoprostol. We, therefore, conducted research to confirm high fever rates following PPH treatment with misoprostol in another Latin American population, Argentina, to improve our understanding of misoprostol’s side effects and predictors of elevated temperature.…”

Section: Introductionmentioning

confidence: 99%

High fever after sublingual administration of misoprostol for treatment of post‐partum haemorrhage: a hospital‐based, prospective observational study in Argentina

Durocher

Aguirre²,

Dzuba

et al. 2020

Tropical Med Int Health

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objective To characterise the occurrence of fever (≥38.0°C) after treatment for post-partum haemorrhage (PPH) with sublingual misoprostol 800 mcg in Latin America, where elevated rates of misoprostol's thermoregulatory effects and recipients' increased susceptibility to high fever have been documented.methods A prospective observational study in hospitals in Argentina enrolled consenting women with atonic PPH after vaginal delivery, eligible to receive misoprostol. Corporal temperature was assessed at 30, 60, 90 and 120 min post-treatment; other effects were recorded. The incidence of high fever ≥ 40.0°C (primary outcome) was compared to the rate observed previously in Ecuador. Logistic regressions were performed to identify clinical and population-based predictors of misoprostolinduced fever.results Transient shivering and fever were experienced by 75.5% (37/49) of treated participants and described as acceptable by three-quarters of women interviewed (35/47). The high fever rate was 12.2% (6/49), [95% Confidence Interval (CI) 4.6, 24.8], compared to Ecuador's rate following misoprostol treatment (35.6% (58/163) [95% CI 28.3, 43.5], P = 0.002). Significant predictors of misoprostolinduced fever (model dependent) were as follows: pre-delivery haemoglobin < 11.0g/dl, rapid placental expulsion, and higher age of the woman. No serious outcomes were reported prior to discharge.conclusions Misoprostol to treat PPH in Argentina resulted in a significantly lower rate of high fever than in Ecuador, although both are notably higher than rates seen elsewhere. A greater understanding of misoprostol's side effects and factors involved in their occurrence, including genetics, will help alleviate concerns. The onset of shivering may be the simplest way to know if fever can also be expected.keywords misoprostol, fever, post-partum haemorrhage, sublingual, Argentina, Latin America Sustainable Development Goals (SDGs): SDG 3 (good health and well-being), SDG 17 (partnerships for the goals)

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Risk of Fever After Misoprostol for the Prevention of Postpartum Hemorrhage

Cited by 28 publications

References 0 publications

Comparison of Use of Misoprostol versus Manual Vacuum Aspiration in the Treatment of Incomplete Abortion

Comparison of Use of Misoprostol versus Manual Vacuum Aspiration in the Treatment of Incomplete Abortion

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

High fever after sublingual administration of misoprostol for treatment of post‐partum haemorrhage: a hospital‐based, prospective observational study in Argentina

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