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Database - Alliance francophone pour l'accouchement respecté (AFAR)

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Created on : 22 Jan 2004
Modified on : 25 Jun 2018

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Bibliographical entry (without author) :

Oral misoprostol for the third stage of labor: a randomized controlled trial. Obstetrics & Gynecology 2003;101(5):921-928.

Author(s) :

Eray Ali Kan, Dilbaz B, Meydanli MM, Öztürk N, Narin MA, Haberal A.

Year of publication :


URL(s) :

Résumé (français)  :

Abstract (English)  :

OBJECTIVE : To compare oral misoprostol with conventional oxytocics in the management of the third stage of labor.

METHODS : In a controlled trial, 1574 women were randomized into four groups, as follows: Group 1 received intravenous infusion of oxytocin 10 IU plus oral misoprostol 400 microg, followed by two doses of oral misoprostol 100 microg 4 hours apart; group 2 received oral misoprostol 400 microg, followed by two doses of oral misoprostol 100 microg 4 hours apart; group 3 received intravenous infusion of oxytocin 10 IU; and group 4 received intravenous infusion of oxytocin 10 IU plus intramuscular administration of methylergonovine maleate (Methergine) 0.2 mg. The incidence of postpartum hemorrhage and decrease in hemoglobin concentration from before delivery to 24 hours postpartum were the main outcome measures.

RESULTS : The primary outcome measures were similar in groups 2 and 3. The incidence of postpartum hemorrhage was 9% in group 2, compared with 3.2% in group 1 and 3.5% in group 4 (P < .01, and P = .01, respectively). There were no significant differences among the four groups regarding hemoglobin concentrations. Significantly more women needed additional oxytocin in group 2, when compared with group 4 (5.9% versus 2.2%; P = .01). The proportion of women requiring additional methylergonovine maleate was 4.8% in group 2, compared with 0.7% in group 1 and 1% in group 4 (P < .01 and P = .01, respectively).

CONCLUSION : Oral misoprostol alone is as effective as oxytocin alone for the prevention of postpartum hemorrhage; it is less effective than oxytocin plus methylergonovine maleate and oral misoprostol plus oxytocin.

Sumário (português)  :

Comments :

Argument (français) :

Comparaison entre l’utilisation de misoprostol par voie orale et celle d’ocytociques conventionnels. (Essai randomisé sur 1574 patientes) Le groupe qui n’a reçu que du misoprostol par voie orale a fait 9% d’hémorragies post-partum, contre 3% pour d’autres groupes ayant reçu de l’ocytocine en intraveineuse.

Argument (English):

Comparison between the use of oral misoprostol and that of conventional oxytocics. (Randomized trial of 1574 patients) The group receiving only oral misoprostol had 9% postpartum haemorrhage, compared with 3% for other groups who received oxytocin intravenously.

Argumento (português):

Comparação entre o uso de misoprostol por via oral e o uso de ocitócicos convencionais (Ensaio randomizado de 1574 pacientes) O grupo que recebeu apenas misoprostol oral teve 9% de hemorragia pós-parto, em comparação com 3% para outros grupos que receberam ocitocina por via intravenosa.

Keywords :

➡ duration of labour ; evidence-based medicine/midwifery ; prevention ; active management of labor ; oxytocin ; postpartum hemorrhage ; hormones ; misoprostol (Cytotec) ; induction of labor

Author of this record :

Cécile Loup — 22 Jan 2004
➡ latest update : Marion Corbe — 25 Jun 2018

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