title: Advance misoprostol distribution for preventing and treating postpartum haemorrhage.
abstract: BACKGROUND
  Advance community distribution of misoprostol for preventing or treating postpartum haemorrhage (PPH) has become an attractive strategy to expand uterotonic coverage to places where conventional uterotonic use is not feasible. However, the value and safety of this strategy remain contentious.
  
  
  OBJECTIVE
  To assess the effectiveness and safety of a strategy of advance misoprostol distribution for PPH prevention and treatment in non-facility births.
  
  
  METHODS
  We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (5 October 2011). We did not apply any language restrictions.
  
  
  METHODS
  Randomised or quasi-randomised controlled trials of advance misoprostol distribution to lay health workers or pregnant women compared with usual care for PPH prevention or treatment in non-facility births. We excluded studies without any form of random design.
  
  
  METHODS
  Two review authors independently assessed trial eligibility for inclusion.
  
  
  RESULTS
  The search strategies identified three studies. None of the studies met the inclusion criteria.
  
  
  CONCLUSIONS
  There is no evidence from randomised or quasi-randomised trials on the benefits or risks of a strategy of advance misoprostol distribution for PPH prevention or treatment in non-facility births. In view of the increasing interest to scale up this strategy, there is an urgent need for large and well-designed randomised trials to evaluate its comparative benefits and risks.
authors.affiliation: Maternal and Fetal Health Research Unit, Department of Obstetrics and Gynaecology, Obafemi Awolowo College of Health Sciences, Olabisi Onabanjo University, Sagamu, Ogun State, Nigeria. tixon y2k@hotmail.com
authors.forename: Olufemi T
authors.initials: OT
authors.lastname: Oladapo
authors.forename: Bukola
authors.initials: B
authors.lastname: Fawole
authors.forename: Jennifer
authors.initials: J
authors.lastname: Blum
authors.forename: Edgardo
authors.initials: E
authors.lastname: Abalos
mesh_terms: D005260:Female; D006801:Humans; D016595:Misoprostol / Q000600:supply & distribution*; D010120:Oxytocics / Q000600:supply & distribution*; D006473:Postpartum Hemorrhage / Q000517:prevention & control*; D011247:Pregnancy
chemical_list: D010120:Oxytocics; D016595:Misoprostol