Misoprostol Does Not Decrease Postpartum Hemorrhage

Also tied to increased shivering, body temperature when added to standard uterotonic therapy
By Lindsey Marcellin
HealthDay Reporter

FRIDAY, May 21 (HealthDay News) -- The prostaglandin analogue misoprostol, when added to standard uterotonic therapy, does not result in decreased postpartum blood loss, according to research published in the May 22 issue of The Lancet.

Mariana Widmer, M.Sc., of the World Health Organization, Geneva, Switzerland, and colleagues conducted a randomized double-blind, multicenter international study of 1,422 women diagnosed with postpartum hemorrhage due to uterine atony. In the intervention arm of the study, the women received 600 micrograms of misoprostol, sublingually, in addition to the standard therapy of uterotonics. This group was compared to the control group of women who received only the standard uterotonic therapy.

The misoprostol group and the standard therapy group had the same proportion of women (14 percent) with blood loss of 500 mL or greater within 60 minutes. A higher proportion of women in the misoprostol group versus the standard therapy group had shivering (65 percent and 32 percent, respectively) and body temperature of 38 degrees Celsius (100.4 F) or greater (43 percent and 15 percent, respectively).

"The findings of this trial do not support the use of misoprostol in addition to other conventional uterotonics for the treatment of atonic postpartum hemorrhage. Any further research on misoprostol should focus on the possible effectiveness of misoprostol in settings where standard uterotonics are not available," the authors write.

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