J Hua1, G Chen, F Xing, M Scott, Q Li. 1. Department of Obstetrics and Gynaecology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China.
Abstract
BACKGROUND: The efficacy of misoprostol versus oxytocin for reducing blood loss during caesarean section remains unclear. OBJECTIVES: To conduct a meta-analysis comparing the efficacy of misoprostol with that of oxytocin in reducing blood loss during caesarean section. SEARCH STRATEGY: We searched MEDLINE, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL) and ClinicalTrials.gov for randomised controlled trials (RCTs) using the keywords 'misoprostol', 'oxytocin' and 'caesarean section'. SELECTION CRITERIA: Refereed publications examining the efficacy of misoprostol and oxytocin for reducing blood loss during caesarean section. DATA COLLECTION AND ANALYSIS: Two of the authors independently abstracted data from original articles. A fixed-effects or random-effects model was used, depending on the heterogeneity of the data, to estimate the risk ratio (RR), risk difference (RD) or weighted mean difference (WMD) with 95% confidence intervals (95% CIs). MAIN RESULTS: A total of 646 pregnant women were included in this analysis. There was a significant difference in estimated blood loss between the misoprostol and the oxytocin groups (WMD-64.09; 95% CI-119.86--8.31). However, differences in haemoglobin levels (WMD-0.04; 95% CI-0.18-0.10), additional oxytocic therapy requirements (RD .03; 95% CI -0.04-0.10) and blood transfusion requirements (RD 0.00; 95% CI-0.03-0.02) between the two groups failed to reach statistical significance. The incidence of postoperative shivering/pyrexia was significantly higher in the misoprostol group, compared with the oxytocin group (RR 3.23; 95% CI 1.41-7.39). AUTHORS' CONCLUSIONS: The results suggest that misoprostol is as effective as oxytocin for reducing blood loss during caesarean section. However, further research into treatment strategies is needed.
BACKGROUND: The efficacy of misoprostol versus oxytocin for reducing blood loss during caesarean section remains unclear. OBJECTIVES: To conduct a meta-analysis comparing the efficacy of misoprostol with that of oxytocin in reducing blood loss during caesarean section. SEARCH STRATEGY: We searched MEDLINE, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL) and ClinicalTrials.gov for randomised controlled trials (RCTs) using the keywords 'misoprostol', 'oxytocin' and 'caesarean section'. SELECTION CRITERIA: Refereed publications examining the efficacy of misoprostol and oxytocin for reducing blood loss during caesarean section. DATA COLLECTION AND ANALYSIS: Two of the authors independently abstracted data from original articles. A fixed-effects or random-effects model was used, depending on the heterogeneity of the data, to estimate the risk ratio (RR), risk difference (RD) or weighted mean difference (WMD) with 95% confidence intervals (95% CIs). MAIN RESULTS: A total of 646 pregnant women were included in this analysis. There was a significant difference in estimated blood loss between the misoprostol and the oxytocin groups (WMD-64.09; 95% CI-119.86--8.31). However, differences in haemoglobin levels (WMD-0.04; 95% CI-0.18-0.10), additional oxytocic therapy requirements (RD .03; 95% CI -0.04-0.10) and blood transfusion requirements (RD 0.00; 95% CI-0.03-0.02) between the two groups failed to reach statistical significance. The incidence of postoperative shivering/pyrexia was significantly higher in the misoprostol group, compared with the oxytocin group (RR 3.23; 95% CI 1.41-7.39). AUTHORS' CONCLUSIONS: The results suggest that misoprostol is as effective as oxytocin for reducing blood loss during caesarean section. However, further research into treatment strategies is needed.
Authors: Mansoureh Sadeghi Afkham; Maryam Hashemnejad; Sara Esmaelzadeh Saeieh; Mina Ataei; Rohollah Valizadeh Journal: Ann Med Surg (Lond) Date: 2022-07-20