Rectal misoprostol versus intravenous oxytocin for the prevention of postpartum hemorrhage after vaginal delivery

Citation
Ts. Gerstenfeld et Da. Wing, Rectal misoprostol versus intravenous oxytocin for the prevention of postpartum hemorrhage after vaginal delivery, AM J OBST G, 185(4), 2001, pp. 878-882
Citations number
21
Categorie Soggetti
Reproductive Medicine","da verificare
Journal title
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY
ISSN journal
00029378 → ACNP
Volume
185
Issue
4
Year of publication
2001
Pages
878 - 882
Database
ISI
SICI code
0002-9378(200110)185:4<878:RMVIOF>2.0.ZU;2-L
Abstract
OBJECTIVE: To compare rectally administered misoprostol to intravenously ad ministered oxytocin for the management of third-stage labor. STUDY DESIGN: Subjects were randomized to receive two, 200-mug misoprostol tablets rectally (study medication) plus 2 mL saline in Ringer's lactate in travenously or two lactose tablets rectally plus 20 units oxytocin in Ringe r's lactate intravenously (control medication). Blood loss was determined b y estimation, measurement, and change in hematocrit values from admission t o postpartum day 1. Subjects were excluded if cesarean delivery was require d. RESULTS: A total of 325 women underwent analysis. By estimation, 21 % of su bjects and 15% of controls had postpartum hemorrhage (P =.17). By using mea sured blood loss, we determined that 70 of 154 (46%) study subjects and 61 of 161 (38%) control subjects had postpartum hemorrhage (P =.17). For 36 (2 3%) misoprostol subjects and 18 (11%) oxytocin subjects at least one additi onal agent was required to control bleeding (P =.004). CONCLUSION: Rectal misoprostol (400 mug) was no more effective than intrave nous oxytocin in preventing postpartum hemorrhage.