OBJECTIVE: To evaluate whether routine administration of sublingual misoprostol 600 microg after delivery reduces postpartum haemorrhage. DESIGN: Randomised double blind placebo controlled trial. SETTING:Primary health centre in Bissau, Guinea-Bissau, West Africa. PARTICIPANTS: 661 women undergoing vaginal delivery. INTERVENTION: Misoprostol 600 mug or placebo administered sublingually immediately after delivery. MAIN OUTCOME MEASURES: Postpartum haemorrhage, defined as a loss of >; or = 500 ml and decrease in haemoglobin concentration after delivery. RESULTS: The incidence of postpartum haemorrhage was not significantly different between the two groups, the relative risk being 0.89 (95% confidence interval 0.76 to 1.04) in the misoprostol group compared with the placebo group. Mean blood loss was 10.5% (-0.5% to 20.4%) lower in the misoprostol group than in the control group. Severe postpartum haemorrhage of > or = 1000 ml or > or = 1500 ml occurred in 17% (56) and 8% (25) in the placebo group and 11% (37) and 2% (7) in the misoprostol group. Significantly fewer women in the misoprostol group experienced a loss of >; or = 1000 ml (0.66, 0.45 to 0.98) or > or = 1500 ml (0.28, 0.12 to 0.64). The decrease in haemoglobin concentration tended to be less in the misoprostol group, the mean difference between the two groups being 0.16 mmol/l (-0.01 mmol/l to 0.32 mmol/l). CONCLUSION:Sublingual misoprostol reduces the frequency of severe postpartum haemorrhage.
RCT Entities:
OBJECTIVE: To evaluate whether routine administration of sublingual misoprostol 600 microg after delivery reduces postpartum haemorrhage. DESIGN: Randomised double blind placebo controlled trial. SETTING: Primary health centre in Bissau, Guinea-Bissau, West Africa. PARTICIPANTS: 661 women undergoing vaginal delivery. INTERVENTION: Misoprostol 600 mug or placebo administered sublingually immediately after delivery. MAIN OUTCOME MEASURES: Postpartum haemorrhage, defined as a loss of > or = 500 ml and decrease in haemoglobin concentration after delivery. RESULTS: The incidence of postpartum haemorrhage was not significantly different between the two groups, the relative risk being 0.89 (95% confidence interval 0.76 to 1.04) in the misoprostol group compared with the placebo group. Mean blood loss was 10.5% (-0.5% to 20.4%) lower in the misoprostol group than in the control group. Severe postpartum haemorrhage of > or = 1000 ml or > or = 1500 ml occurred in 17% (56) and 8% (25) in the placebo group and 11% (37) and 2% (7) in the misoprostol group. Significantly fewer women in the misoprostol group experienced a loss of > or = 1000 ml (0.66, 0.45 to 0.98) or > or = 1500 ml (0.28, 0.12 to 0.64). The decrease in haemoglobin concentration tended to be less in the misoprostol group, the mean difference between the two groups being 0.16 mmol/l (-0.01 mmol/l to 0.32 mmol/l). CONCLUSION: Sublingual misoprostol reduces the frequency of severe postpartum haemorrhage.
Authors: A M Gülmezoglu; J Villar; N T Ngoc; G Piaggio; G Carroli; L Adetoro; H Abdel-Aleem; L Cheng; G Hofmeyr; P Lumbiganon; C Unger; W Prendiville; A Pinol; D Elbourne; H El-Refaey; K Schulz Journal: Lancet Date: 2001-09-01 Impact factor: 79.321
Authors: Stacie E Geller; Shivaprasad S Goudar; Marci G Adams; Vijaya A Naik; Ashlesha Patel; Mrutyunjaya B Bellad; Shobhana S Patted; Stanley A Edlavitch; Nancy Moss; Bhalchandra S Kodkany; Richard J Derman Journal: Int J Gynaecol Obstet Date: 2008-03-04 Impact factor: 3.561
Authors: G Justus Hofmeyr; A Metin Gülmezoglu; Natalia Novikova; Verena Linder; Sandra Ferreira; Gilda Piaggio Journal: Bull World Health Organ Date: 2009-09 Impact factor: 9.408
Authors: Suellen Miller; Carrie Tudor; Vanessa Thorsten; Karma Quzong; Tsering Dekyi; Ty Hartwell; Linda L Wright; Michael W Varner Journal: J Midwifery Womens Health Date: 2009 Mar-Apr Impact factor: 2.388