Premium
Misoprostol versus oxytocin for the reduction of postpartum blood loss
Author(s) -
Baskett T.F.,
Persad V.L.,
Clough H.J.,
Young D.C.
Publication year - 2007
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2006.12.016
Subject(s) - medicine , misoprostol , oxytocin , obstetrics , blood loss , reduction (mathematics) , anesthesia , pregnancy , surgery , abortion , genetics , biology , geometry , mathematics
Objective : To compare the effect of 400 μg of oral misoprostol with 5 U of intravenous oxytocin in the reduction of postpartum blood loss and prevention of postpartum hemorrhage. Methods : In a prospective, double‐blind, randomized controlled trial conducted in a tertiary maternity hospital 622 women received either 400 μg of oral misoprostol or 5 U of intravenous oxytocin after delivery of the anterior shoulder or within 1 min of delivery. The primary outcome was a hematocrit drop of 10% or greater 24 h postpartum. The secondary outcomes were a hemoglobin drop of 30 mg/L or greater, the use of additional oxytocin, an estimated blood loss greater than 1000 mL, manual removal of the placenta, a blood transfusion, and shivering and fever (≥ 38 °C) as adverse effects of misoprostol. Results : There was no difference between the 2 groups regarding the primary outcome (a ≥ 10% hematocrit drop occurred in 3.4% and 3.7% of the participants in the oxytocin and misoprostol groups, P = 0.98). The rate of use of additional oxytocin was higher in the misoprostol group (51% versus 40.5%, P = 0.01). Shivering was confined to the misoprostol group (6.8%), and fever occurred in 12.5% of the women in the misoprostol group and 0.3% of the women in the oxytocin group. Conclusion : The routine use of 400 μg of oral misoprostol was no less effective than 5 U of intravenous oxytocin in reducing blood loss after delivery, as assessed by change in postpartum hematocrit. The adverse effects of misoprostol were mild and self‐limiting.