Abstract | OBJECTIVE: STUDY DESIGN: Systematic review and metaanalysis of randomized controlled trials. RESULTS: Seventeen studies (3174 women) were included of which 7 evaluated misoprostol vs oxytocin and 8 evaluated misoprostol plus oxytocin vs oxytocin alone. Overall, there were no significant differences in intraoperative and postoperative hemorrhage between sublingual or oral misoprostol and oxytocin. Rectal misoprostol, compared with oxytocin, was associated with a significant reduction in intraoperative and postoperative hemorrhage. The combined use of sublingual misoprostol and oxytocin, compared with the use of oxytocin alone, was associated with a significant reduction in the mean decrease in hematocrit (mean difference, -2.1%; 95% confidence interval, -3.4 to -0.8) and use of additional uterotonic agents (relative risk, 0.33; 95% confidence interval, 0.18-0.62). Compared with oxytocin alone, buccal misoprostol plus oxytocin reduced the use of additional uterotonic agents; rectal misoprostol plus oxytocin decreased intraoperative and postoperative blood loss, mean fall in hematocrit, and use of additional uterotonic agents; and intrauterine misoprostol plus oxytocin reduced the mean fall in hemoglobin and hematocrit. Women receiving misoprostol, alone or combined with oxytocin, had a higher risk of shivering and pyrexia. CONCLUSION:
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Authors | Agustín Conde-Agudelo, Aníbal Nieto, Anyeli Rosas-Bermudez, Roberto Romero |
Journal | American journal of obstetrics and gynecology
(Am J Obstet Gynecol)
Vol. 209
Issue 1
Pg. 40.e1-40.e17
(Jul 2013)
ISSN: 1097-6868 [Electronic] United States |
PMID | 23507545
(Publication Type: Journal Article, Meta-Analysis, Research Support, N.I.H., Intramural, Review, Systematic Review)
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Copyright | Copyright © 2013 Mosby, Inc. All rights reserved. |
Chemical References |
- Oxytocics
- Misoprostol
- Oxytocin
|
Topics |
- Cesarean Section
- Female
- Humans
- Intraoperative Complications
(prevention & control)
- Misoprostol
(administration & dosage)
- Oxytocics
(administration & dosage)
- Oxytocin
(administration & dosage)
- Postpartum Hemorrhage
(prevention & control)
- Pregnancy
- Uterine Hemorrhage
(prevention & control)
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