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Objective: To evaluate whether routine administration of sublingual misoprostol 600 μg after delivery reduces postpartum haemorrhage. Design: Randomised double blind placebo controlled trial. Setting: Primary health centre in Bissau, Guinea-Bissau, West Africa. Participants: 661 women undergoing vaginal delivery. Intervention: Misoprostol 600 μg or placebo administered sublingually immediately after delivery. Main outcome measures: Postpartum haemorrhage, defined as a loss of ≥500 ml and decrease in haemoglobin concentration after delivery. Results: The incidence of postpartum haemorrhage was not significantly different between the two groups, the relative risk being 0.89 (95%confidence interval 0.76 to 1.04) in the misoprostol group compared with the placebo group. Mean blood loss was 10.5%(-0.5%to 20.4%)-lower in the misoprostol group than in the control group. Severe postpartum haemorrhage of ≥1000 ml or ≥1500 ml occurred in 17%(56) and 8%(25) in the placebo group and 11%(37) and 2%(7) in the misoprostol group. Significantly fewer women in the misoprostol group experienced alossof ≥1000 ml (0.66, 0.45 to 0.98) or ≥1500 ml (0.28, 0.12 to 0.64). The decrease in haemoglobin concentration tended to be less in the misoprostol group, the mean difference between the two groups being 0.16 mmol/l (-0.01 mmol/1 to 0.32 mmol/l). Conclusion: Sublingual misoprostol reduces the frequency of severe postpartum haemorrhage.
Objective: To evaluate whether routine administration of sublingual misoprostol 600 μg after delivery reduces postpartum haemorrhage. Design: Randomized double blind placebo controlled trial. Setting: Primary health center in Bissau, Guinea-Bissau, West Africa. Participants: 661 women undergoing vaginal delivery. Intervention: Misoprostol 600 μg or placebo administered sublingually immediately after delivery. Main outcome measures: Postpartum haemorrhage, defined as a loss of ≥ 500 ml and decrease in hemoglobin concentration after delivery. Results: The incidence of postpartum haemorrhage was not significantly different between the two groups, the relative risk being 0.89 (95% confidence interval 0.76 to 1.04) in the misoprostol group compared with the placebo group. Mean blood loss was 10.5% (-0.5% to 20.4%) - lower in the misoprostol group than in the control group. Severe postpartum haemorrhage of ≥1000 ml or ≥1500 ml occurred in 17% (56) and 8% (25) in the placebo group and 11% (37 ) and 2% (7) in the misoprostol group. Significantly fewer women in the misoprostol group experienced alossof ≥ 1000 ml (0.66, 0.45 to 0.98) or ≥ 1500 ml (0.28, 0.12 to 0.64). The decrease in hemoglobin concentration tended to The mean difference between the two groups is 0.16 mmol / l (-0.01 mmol / 1 to 0.32 mmol / l). Conclusion: Sublingual misoprostol reduces the frequency of severe postpartum haemorrhage.