Effect of sublingual misoprostol on severe postpartum haemorrhage in a primary health centre in Guinea-Bissau: randomised double blind clinical trial.
OBJECTIVE
To evaluate whether routine administration of sublingual misoprostol 600 microg after delivery reduces postpartum haemorrhage.


METHODS
Randomised double blind placebo controlled trial.


METHODS
Primary health centre in Bissau, Guinea-Bissau, West Africa.


METHODS
661 women undergoing vaginal delivery.


METHODS
Misoprostol 600 mug or placebo administered sublingually immediately after delivery.


METHODS
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).


CONCLUSIONS
Sublingual misoprostol reduces the frequency of severe postpartum haemorrhage.
Høj
Lars
L
Department of Obstetrics and Gynaecology, Aarhus University Hospital, 8200 Aarhus N, Denmark. lars.hoj@dadlnet.dk
Cardoso
Placido
P
Nielsen
Birgitte Bruun
BB
Hvidman
Lone
L
Nielsen
Jens
J
Aaby
Peter
P
D000286:Administration, Sublingual; D000328:Adult; D004311:Double-Blind Method; D005260:Female; D006169:Guinea-Bissau; D006801:Humans; D016595:Misoprostol / Q000008:administration & dosage* / Q000009:adverse effects; D010120:Oxytocics / Q000008:administration & dosage* / Q000009:adverse effects; D006473:Postpartum Hemorrhage / Q000517:prevention & control*; D011247:Pregnancy; D012307:Risk Factors; D013607:Tablets; D016896:Treatment Outcome
D010120:Oxytocics; D013607:Tablets; D016595:Misoprostol