title: Safety and efficacy of misoprostol versus oxytocin for the prevention of postpartum hemorrhage.
abstract: Postpartum hemorrhage (PPH) is the commonest cause of maternal death worldwide. Studies suggest that the use of misoprostol may be beneficial in clinical settings where oxytocin is unavailable. The aim of this study was to compare the safety and efficacy of oxytocin and misoprostol when used in the prevention of PPH. In a double-blind randomized controlled trial, 400 pregnant women who had a vaginal delivery were assigned into two groups: to receive either 20 IU of oxytocin in 1000 mL Ringer's solution and two placebo tablets or 400 mcg oral misoprostol (as two tablets) and 2 mL normal saline in 1000 mL Ringer's solution. The quantity of blood loss was higher in the oxytocin group in comparison to the misoprostol group. There was no significant difference in the decrease in hematocrit and hemoglobin between the two groups. Although there was no significant difference in the need for transfusions between the two groups, the patients in the oxytocin group had greater need for additional oxytocin. Results from this study indicate that it may be considered as an alternative for oxytocin in low resource clinical settings. This study is registered with ClinicalTrials.gov NCT01863706.
authors.affiliation: Hormozgan Fertility and Infertility Research Center, Hormozgan University of Medical Sciences (HUMS), Bandar Abbas, Iran.
authors.forename: Minoo
authors.initials: M
authors.lastname: Rajaei
authors.affiliation: Hormozgan Fertility and Infertility Research Center, Hormozgan University of Medical Sciences (HUMS), Bandar Abbas, Iran.
authors.forename: Samieh
authors.initials: S
authors.lastname: Karimi
authors.affiliation: Hormozgan Fertility and Infertility Research Center, Hormozgan University of Medical Sciences (HUMS), Bandar Abbas, Iran.
authors.forename: Zohreh
authors.initials: Z
authors.lastname: Shahboodaghi
authors.affiliation: Infectious and Tropical Diseases Research Center, Hormozgan University of Medical Sciences (HUMS), Bandar Abbas 7914964153, Iran ; Department of Psychology, Payame Noor University (PNU), Tehran, Iran.
authors.forename: Hamidreza
authors.identifier: 0000-0002-3491-8050
authors.initials: H
authors.lastname: Mahboobi
authors.affiliation: Infectious and Tropical Diseases Research Center, Hormozgan University of Medical Sciences (HUMS), Bandar Abbas 7914964153, Iran.
authors.forename: Tahereh
authors.initials: T
authors.lastname: Khorgoei
authors.affiliation: Shiraz University of Medical Sciences (SUMS), Shiraz, Iran.
authors.forename: Farzam
authors.initials: F
authors.lastname: Rajaei
mesh_terms: D000328:Adult; D001803:Blood Transfusion; D004311:Double-Blind Method; D005260:Female; D006400:Hematocrit; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D016595:Misoprostol / Q000627:therapeutic use*; D010120:Oxytocics / Q000627:therapeutic use*; D010121:Oxytocin / Q000627:therapeutic use*; D006473:Postpartum Hemorrhage / Q000097:blood / Q000517:prevention & control* / Q000628:therapy; D011247:Pregnancy; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D006454:Hemoglobins; D010120:Oxytocics; D016595:Misoprostol; D010121:Oxytocin
references.citation: Eur J Obstet Gynecol Reprod Biol. 2005 Nov 1;123(1):87-91
references.pmid: 16260342
references.citation: Lancet. 2010 Jan 16;375(9710):217-23
references.pmid: 20060162
references.citation: Obstet Gynecol. 1997 Oct;90(4 Pt 2):703-4
references.pmid: 11770608
references.citation: Lancet. 2010 May 22;375(9728):1808-13
references.pmid: 20494730
references.citation: Contraception. 1999 Dec;60(6):353-6
references.pmid: 10715370
references.citation: Am J Obstet Gynecol. 1976 Nov 15;126(6):671-7
references.pmid: 984141
references.citation: J Obstet Gynaecol Res. 2007 Dec;33(6):810-7
references.pmid: 18001447
references.citation: Acta Obstet Gynecol Scand. 2001 Sep;80(9):835-9
references.pmid: 11531635
references.citation: Obstet Gynecol. 1997 Jul;90(1):88-92
references.pmid: 9207820
references.citation: Matern Child Health J. 2005 Sep;9(3):297-306
references.pmid: 16132205
references.citation: Best Pract Res Clin Obstet Gynaecol. 2002 Apr;16(2):221-36
references.pmid: 12041964
references.citation: Am J Obstet Gynecol. 2008 Nov;199(5):519.e1-7
references.pmid: 18639209
references.citation: Lancet. 2010 Jan 16;375(9710):210-6
references.pmid: 20060161
references.citation: Cochrane Database Syst Rev. 2007 Jan 24;(1):CD003249
references.pmid: 17253486
references.citation: Clin Obstet Gynecol. 2002 Jun;45(2):330-44
references.pmid: 12048393
references.citation: Am J Obstet Gynecol. 2010 Apr;202(4):353.e1-6
references.pmid: 20350642
references.citation: Mymensingh Med J. 2009 Jan;18(1 Suppl):S40-44
references.pmid: 19377430
references.citation: Int J Gynaecol Obstet. 2007 Apr;97(1):2-5
references.pmid: 17321529