Use of oral misoprostol in the prevention of postpartum haemorrhage

El-Refaey, Hazem; O’Brien, Pat; Morafa, W.; Walder, Jane; Rodeck, Charles H.

doi:10.1111/j.1471-0528.1997.tb11464.x

Cited by 100 publications

(77 citation statements)

References 25 publications

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“…In disagreement with the present outcome, some research work had indicated cases of diarrhoea (3%) in misoprostol group [13,17,18]. In another twist, El-Refaey et al (2000) reported significantly higher incidences of nausea in misoprostol medication group than in standard oxytocics.…”

Section: Discussioncontrasting

confidence: 75%

Comparative study of the side effect profiles of oral misoprostol and parenteral oxytocin used in prevention of postpartum haemorrhage in Maiduguri Nigeria

Uthman¹,

Garba²,

Danazumi³

et al. 2013

OJOG

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The following work compared adverse effects profile and patients' acceptability of intra-venous oxytocin 10 iu and oral misoprostol 600 ug used in the prevention of postpartum hemorrhage in the third stage of labour. A total of 1865 pregnant women who have received either oxytocin injection or oral misoprostol in third stage of labour as prophylaxis for postpartum haemorrhage, were enrolled within three health care facilities in Maiduguri, Nigeria. Each patient was observed at parturition and for 24 h after during which oral interviews were conducted and clinical notes studied. The oxytocin medication group exhibited higher abdominal pains (7.1% versus 0.0%; p < 0.001) and headache (1.9% versus 0.1%; p < 0.001), while the misoprostol group showed higher shivering (33.9% versus 0.0%; p < 0.001) and fever (19.7% versus 1.8%; p < 0.001). There were no significant differences in other side effects like nausea and vomiting. There was no statistically significant (p > 0.05) difference in patients acceptability of injectable oxytocin (99.3%) and oral misoprostol (98.3%). Oxytocin usage in the prevention of PPH was associated with abdominal pains and headache while misoprostol was associated with shivering and fever. Patients from this study have demonstrated high level of acceptability of both parenteral oxytocin and oral misopristol prevention of post-partum haemorrhage.

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Section: Discussioncontrasting

confidence: 75%

Comparative study of the side effect profiles of oral misoprostol and parenteral oxytocin used in prevention of postpartum haemorrhage in Maiduguri Nigeria

Uthman¹,

Garba²,

Danazumi³

et al. 2013

OJOG

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“…The difference was statistically significant between rectal misoprostol and IM 15methyl-PGF2α group (p< 0.001) and also between oral misoprostol and rectal misoprostol group (p=0.041). The findings were comparable to El Refaey et al study 27 .…”

Section: Nauseasupporting

confidence: 82%

Role of oral misoprostol, rectal misoprostol and intramuscular 15-methyl-PGF2α for prophylaxis of postpartum haemorrhage

Pandey

2017

Int J Reprod Contracept Obstet Gynecol

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INTRODUCTIONPostpartum haemorrhage is the most common cause of maternal mortality and accounts for one quarter of maternal deaths worldwide. Approximately 28% of maternal deaths worldwide are due to haemorrhage, mostly in the postpartum period. Most maternal deaths due to PPH occur in developing countries in settings where there are no birth attendants or where birth attendants lack the necessary skills or equipment to prevent PPH and shock. To improve the maternal mortality ratio further from ~174 per 100,000 live births in 2015, we have to put focussed attention to confronting the problem of PPH in India. 1,2 Despite safe motherhood activities since 1987, women are still dying in childbirth. Women living in low resource settings are most vulnerable due to concurrent disease, poverty, discrimination and limited access to health care. Indeed 99% of maternal deaths occur in developing countries that have an inadequate transport system, limited access to skilled caregivers and ABSTRACT Background: Postpartum haemorrhage (PPH) is the most common cause of maternal mortality. Approximately 28% of maternal deaths worldwide are due to haemorrhage, mostly in the postpartum period. The WHO estimates that of the 303,000 maternal deaths occurring every year, 45,000 takes place in India, where two third of maternal deaths occur after delivery, PPH being the most common cause of death (29.6%). This study compared oral misoprostol, rectal misoprostol and intramuscular 15methyl-PGF2α for prophylaxis of postpartum haemorrhage in terms of various outcomes such as drop in Hb concentration after delivery, the amount of blood loss during delivery and duration of third stage of labour. Methods: Randomized comparative trial in 1:1:1 ratio of oral misoprostol, rectal misoprostol and IM 15methyl-PGF2α groups of 300 low risk pregnant women (with singleton pregnancy and ≥28 weeks gestation age) who underwent normal vaginal delivery at Kasturba hospital during 1 year period. Results: The mean blood loss was significantly less in IM 15methyl-PGF2α group as compared to oral and rectal misoprostol groups. Incidence of PPH was least in IM 15methyl-PGF2α group as compared to oral and rectal misoprostol groups but the difference observed was not statistically significant. Maximum cases with Hb drop > 1 gm/dl were present in the rectal misoprostol group. Conclusions: IM 15methyl-PGF2α was found to be most effective and rectal misoprostol was found to be least effective for prophylaxis of PPH. Gastrointestinal side effects like nausea, vomiting and diarrhoea were significantly higher in the IM 15methyl-PGF2α group, however it had much lower incidence of shivering and pyrexia.

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“…Following earlier uncontrolled reports 2,3 of misoprostol use during the third stage of labour, a large multicentre trial was conducted by WHO to evaluate the effectiveness of 600 Ag misoprostol compared with 10 IU of oxytocin 4 . This large randomised controlled trial and a systematic review of seven randomised controlled trials 5 demonstrated that 10 IU of oxytocin (im or iv) is preferable to 600 Ag misoprostol given orally in the active management of the third stage of labour in hospital settings where active management is the norm.…”

Section: Introductionmentioning

confidence: 99%

Side effects of oral misoprostol during the first 24 hours after administration in the third stage of labour

Lumbiganon¹

2002

BJOG: An International Journal of Obstetrics and Gynaecology

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For the WHO Collaborative Group to Evaluate Misoprostol in the Management of the Third Stage of LabourObjective To evaluate the side effects of 600 Ag misoprostol orally during the first 24 hours after administration in the third stage of labour. Design Double blind randomised controlled trial. Setting Tertiary care hospitals in Nigeria and Thailand. Sample All women participating in the WHO Misoprostol trial in these two hospitals between January 1, 1999and June 17, 1999. Methods All women were followed up during the first 24 hours postpartum to evaluate the occurrence of shivering, nausea, vomiting, diarrhoea and other misoprostol-related side effects. Main outcome measures Rates of shivering, nausea, vomiting, diarrhoea and pyrexia within 1 hour and in the intervals 2-6, 7-12, 13-18 and 19 -24 hours after delivery. Results A total of 1686 women were enrolled. Women who received misoprostol had higher incidence than the oxytocin group of 'any' shivering in the first hour (RR 6.4, 95% CI 3.9 to 10.4) and the period covering 2-6 hours following delivery (RR 4.7, 95% CI 1.9 to 11.2). Pyrexia was also more common in the misoprostol group in both the same time intervals (RR 2.8, 95% CI 1.4 to 5.3 and RR 6.3, 95% CI 3.7 to 10.8, respectively). Diarrhoea was not present in the first hour in either group but appeared in the second time period (2-6 hours) and third time period (7-12 hours) more frequently in the misoprostol group than with oxytocin. Conclusion The increased incidence of shivering and pyrexia that occurs with postpartum use of misoprostol persists up to 6 hours following delivery. Approximately 5% of women experience diarrhoea that starts after 1 hour and subsides within 12 hours.

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Use of oral misoprostol in the prevention of postpartum haemorrhage

Cited by 100 publications

References 25 publications

Comparative study of the side effect profiles of oral misoprostol and parenteral oxytocin used in prevention of postpartum haemorrhage in Maiduguri Nigeria

Comparative study of the side effect profiles of oral misoprostol and parenteral oxytocin used in prevention of postpartum haemorrhage in Maiduguri Nigeria

Role of oral misoprostol, rectal misoprostol and intramuscular 15-methyl-PGF2α for prophylaxis of postpartum haemorrhage

Side effects of oral misoprostol during the first 24 hours after administration in the third stage of labour

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