29933
document
Misoprostol versus oxytocin for the reduction of postpartum blood loss . OBJECTIVE To compare the effect of 400 mug 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 mug 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 ( > or=38 degrees C ) as adverse effects of misoprostol . RESULTS There was no difference between the 2 groups regarding the primary outcome ( a > or=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 microg 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 .
29934
Intervention_Pharmacological
Misoprostol
29935
Intervention_Pharmacological
oxytocin
29936
Intervention_Pharmacological
oral misoprostol
29937
Intervention_Pharmacological
intravenous oxytocin
29938
Intervention_Pharmacological
oral misoprostol
29939
Intervention_Pharmacological
intravenous oxytocin
29940
Intervention_Pharmacological
oxytocin
29941
Intervention_Pharmacological
misoprostol
29942
Intervention_Pharmacological
oxytocin
29943
Intervention_Pharmacological
misoprostol
29944
Intervention_Pharmacological
oxytocin
29945
Intervention_Pharmacological
misoprostol
29946
Intervention_Pharmacological
misoprostol
29947
Intervention_Pharmacological
misoprostol
29948
Intervention_Pharmacological
oxytocin
29949
Intervention_Pharmacological
misoprostol
29950
Intervention_Pharmacological
oxytocin
29951
Intervention_Pharmacological
misoprostol
29952
Outcome_Physical
postpartum blood loss .
29953
Outcome_Physical
postpartum blood loss
29954
Outcome_Physical
hematocrit drop of 10 % or greater 24 h postpartum .
29955
Outcome_Adverse-effects
hemoglobin drop of 30 mg/L or greater
29956
Outcome_Physical
use of additional oxytocin
29957
Outcome_Adverse-effects
estimated blood loss greater than 1000 mL
29958
Outcome_Physical
manual removal of the placenta
29959
Outcome_Physical
blood transfusion
29960
Outcome_Adverse-effects
shivering
29961
Outcome_Adverse-effects
fever
29962
Outcome_Physical
use of additional oxytocin
29963
Outcome_Adverse-effects
Shivering
29964
Outcome_Physical
blood loss
29965
Participant_Condition
postpartum
29966
Participant_Sample-size
622
29967
Participant_Sex
women