title: Effect of sublingual misoprostol on severe postpartum haemorrhage in a primary health centre in Guinea-Bissau: randomised double blind clinical trial.
abstract: 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.
authors.affiliation: Department of Obstetrics and Gynaecology, Aarhus University Hospital, 8200 Aarhus N, Denmark. lars.hoj@dadlnet.dk
authors.forename: Lars
authors.initials: L
authors.lastname: Høj
authors.forename: Placido
authors.initials: P
authors.lastname: Cardoso
authors.forename: Birgitte Bruun
authors.initials: BB
authors.lastname: Nielsen
authors.forename: Lone
authors.initials: L
authors.lastname: Hvidman
authors.forename: Jens
authors.initials: J
authors.lastname: Nielsen
authors.forename: Peter
authors.initials: P
authors.lastname: Aaby
mesh_terms: 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
chemical_list: D010120:Oxytocics; D013607:Tablets; D016595:Misoprostol