Misoprostol for prevention and treatment of postpartum haemorrhage : a systematic review
Date
2013-04
Authors
Olefile, Kabelo M.
Khondowe, Oswell
M'Rithaa, Doreen
Journal Title
Journal ISSN
Volume Title
Publisher
AOSIS Open Journals
Abstract
Background: Postpartum haemorrhage (PPH) is a leading cause of maternal mortality especially
in the developing world. Misoprostol, a highly effective drug is highly effective in inducing
uterine contractions and has been proposed as a low-cost, easy-to-use intervention for PPH.
Objective: This study assessed evidence of the effectiveness of misoprostol for the prevention
and treatment of PPH.
Method: Databases searched included MEDLINE, PUBMED, CINHAL, Google Scholar, Cochrane
Central Register of Controlled Trials (CENTRAL) and EMBASE. Reference lists and conference
proceedings were also searched for more studies. Three studies included in the meta-analysis
were limited to randomised controlled trials (RCT). Two reviewers independently screened all
articles for methodological quality using a standardised instrument adapted from the Cochrane
Collaboration website. Data were entered in Review Manager 5.1 software for analysis.
Results: Three trials (n = 2346) compared misoprostol to a placebo. Misoprostol was shown not to
be effective in reducing PPH (risk ratios [RR] 0.65; 95% confidence interval [CI] 0.40–1.06). Only
one trial reported on the need for a blood transfusion (RR 0.14; 95% CI 0.02–1.15). Shivering
(RR 2.75; 95% CI 2.26–3.34) and pyrexia (RR 5.34; 95% CI 2.86–9.96) were significantly more
common with misoprostol than with a placebo.
Conclusion: The use of misoprostol was not associated with any significant reduction in the
incidence of PPH. Therefore, in order to verify the efficacious use of misoprostol in the treatment
of PPH, specialised investigations of its dose and routes of administration for clinically
significant effects and acceptable side effects are warranted.
Description
Publication of this article was funded by the Stellenbosch University Open Access Fund.
The original publication is available at http://www.curationis.org.za/index.php/curationis
The original publication is available at http://www.curationis.org.za/index.php/curationis
Keywords
Postpartum hemorrhage, Uterine hemorrhage, Labor (Obstetrics) -- Complications, Randomized controlled trials
Citation
Olefile, K.M., Khondowe, O. & M’Rithaa, D. 2013. Misoprostol for prevention and treatment of postpartum haemorrhage: a systematic review. Curationis, 36(1), doi:10.4102/curationis.36i1.57.