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Created on : 08 Oct 2004
Modified on : 25 Jun 2018

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Bibliographical entry (without author) :

Randomized controlled trial of rectal misoprostol versus oxytocin in third stage management. J Obstet Gynaecol Can. 2002 Feb;24(2):149-54.

Author(s) :

Karkanis SG, Caloia D, Salenieks ME, Kingdom J, Walker M, Meffe F, Windrim R.

Year of publication :

2002

URL(s) :

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=…

Résumé (français)  :

Abstract (English)  :

OBJECTIVE: To compare rectal misoprostol with oxytocin for routine management of the third stage of labour.

STUDY DESIGN: A total of 240 parturient women were randomized, at three University of Toronto teaching hospitals, to receive either rectal misoprostol (400 microg) after delivery of the infant or parenteral oxytocin (5 units i.v. or 10 units i.m.) with the delivery of the anterior shoulder, when possible, or 5 units i.v. or i.m after the delivery of the placenta. The primary outcome measure was change in hemoglobin (Delta[Hgb]) from admission in early labour to day one postpartum.

SETTING: The labour ward of three University of Toronto teaching hospitals: St. Michael’s, Toronto General, and Mount Sinai.

POPULATION: Labouring women either nulliparous or multiparous with no known risk for excessive third stage blood loss; vertex presentation; no previous Caesarean delivery; induced, spontaneous, or augmented labour.

RESULTS: No difference in Delta[Hgb] was observed between the two groups; the Delta[Hgb] in the oxytocin and misoprostol groups were 1.43 g/L (95% confidence interval [CI], 1.2-1.6 g/L) and 1.59 g/L (95% CI, 1.4-1.8 g/L) respectively (p = 0.35). Secondary outcome measures (excessive third stage bleeding, duration of third stage of labour, need for manual removal of the placenta or the need for additional oxytocics) did not differ between the two groups.

CONCLUSION: Rectal misoprostol is of equivalent efficacy to parenteral oxytocin for the prevention of primary postpartum hemorrhage. Rectal misoprostol is an appropriate uterotonic agent for routine management of the third stage of labour.

Sumário (português)  :

Resumen (español)  :

Comments :

Argument (français) :

Le misoprostol rectal est d’une efficacité équivalente à l’ocytocine par voie parentérale pour la prévention de l’hémorragie primaire post-partum. Le misoprostol rectal est un agent utérotonique approprié pour la prise en charge de routine du troisième stade du travail.

Argument (English):

Rectal misoprostol is of equivalent efficacy to parenteral oxytocin for the prevention of primary postpartum hemorrhage. Rectal misoprostol is an appropriate uterotonic agent for routine management of the third stage of labour.

Argumento (português):

O misoprostol retal é de eficácia equivalente à ocitocina parenteral para a prevenção da hemorragia pós-parto primária. O misoprostol retal é um agente uterotônico apropriado para o manejo rotineiro do terceiro estágio do trabalho de parto.

Argumento (español):

Keywords :

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

Author of this record :

Cécile Loup — 08 Oct 2004
➡ latest update : Marion Corbe — 25 Jun 2018