title: Assessment of sublingual misoprostol as first-line treatment for primary post-partum hemorrhage: results of a multicenter trial.
abstract: OBJECTIVE
  The study investigated the effectiveness of sublingual misoprostol when used as primary treatment of primary post-partum hemorrhage (PPH) in a low-income country.
  
  
  METHODS
  Maternity care providers in three Nigerian hospitals administrated 800 μm sublingual misoprostol to women experiencing PPH. The outcome variables were estimated blood loss and the need for additional uterotonic drugs after initial treatment with misoprostol. Entry criteria included women in term spontaneous labor, while exclusion criteria were women with operative delivery and those experiencing PPH not due to atonic uterus.
  
  
  RESULTS
  One hundred and thirty-one women with PPH were treated over 6 months. Estimated blood loss ranged 500-2500 mL. Twenty women (15.3%) required additional uterotonic drugs to control continuing blood loss. There were no maternal deaths, while seven perinatal deaths were recorded.
  
  
  CONCLUSIONS
  We conclude that although sublingual misoprostol is effective in reducing blood loss due to PPH, it does not effectively treat all forms of PPH. Additional uterotonics and other ancillary treatments would be required.
authors: Department of Obstetrics and Gynecology, University of Benin, Benin City, Rivers State, Nigeria.
authors: Friday Ebhodaghe
authors: FE
authors: Okonofua
authors: Rosemary Nkemdilim
authors: RN
authors: Ogu
authors: James Terkura
authors: JT
authors: Akuse
authors: Innocent Achaya Otobo
authors: IA
authors: Ujah
authors: Hadiza Shehu
authors: HS
authors: Galadanci
authors: Adetokunbo Olusegun
authors: AO
authors: Fabamwo
mesh_terms: D000286:Administration, Sublingual; D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D003906:Developing Countries; D004359:Drug Therapy, Combination; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D016595:Misoprostol / Q000008:administration & dosage* / Q000627:therapeutic use; D009549:Nigeria; D010120:Oxytocics / Q000008:administration & dosage* / Q000627:therapeutic use; D019106:Postoperative Hemorrhage; D006473:Postpartum Hemorrhage / Q000188:drug therapy*; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D055815:Young Adult
chemical_list: D010120:Oxytocics; D016595:Misoprostol
keywords: Nigeria; case management; maternal mortality; misoprostol; post-partum hemorrhage