Should oral misoprostol be used to prevent postpartum haemorrhage in home-birth settings in low-resource countries? A systematic review of the evidence
Authors: Hundley, V., Avan, B., Sullivan, C. and Graham, W.
Journal: BJOG: An International Journal of Obstetrics and Gynaecology
eISSN: 1471-0528
ISSN: 1470-0328
https://eprints.bournemouth.ac.uk/21621/
Source: Scopus
Should oral misoprostol be used to prevent postpartum haemorrhage in home-birth settings in low-resource countries? A systematic review of the evidence
Authors: Hundley, V.A., Avan, B.I., Sullivan, C.J. and Graham, W.J.
Journal: BJOG: An International Journal of Obstetrics and Gynaecology
Volume: 120
Issue: 3
Pages: 277-287
eISSN: 1471-0528
ISSN: 1470-0328
DOI: 10.1111/1471-0528.12049
Abstract:Background Using misoprostol to prevent postpartum haemorrhage (PPH) in home-birth settings remains controversial. Objectives To review the safety and effectiveness of oral misoprostol in preventing PPH in home-birth settings. Search strategy The Cochrane Library, PubMed, and POPLINE were searched for articles published until 31 March 2012. Selection criteria Studies, conducted in low-resource countries, comparing oral misoprostol with a placebo or no treatment in a home-birth setting. Studies of misoprostol administered by other routes were excluded. Data collection and analysis Data were extracted by two reviewers and independently checked for accuracy by a third. The quality of evidence was assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria. Data were sythesised and meta-analysis was performed where appropriate. Main results Ten papers describing two randomised and four non randomised trials. Administration of misoprostol was associated with a significant reduction in the incidence of PPH (RR 0.58, 95% CI 0.38-0.87), additional uterotonics (RR 0.34, 95% CI 0.16-0.73), and referral for PPH (RR 0.49, 95% CI 0.37-0.66). None of the studies was large enough to detect a difference in maternal mortality, and none reported neonatal mortality. Shivering and pyrexia were the most common side effects. Author's conclusions The finding that the distribution of oral misoprostol through frontline health workers is effective in reducing the incidence of PPH could be a significant step forwards in reducing maternal deaths in low-resource countries. However, given the limited number of high-quality studies in this review, further randomised controlled trials are required to confirm the association, particularly in different implementation settings. Adverse effects have not been systematically captured, and there has been limited consideration of the potential for inappropriate or inadvertent use of misoprostol. Further evidence is needed to inform the development of implementation and safety guidelines on the routine availability of misoprostol. © 2012 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2012 RCOG.
https://eprints.bournemouth.ac.uk/21621/
Source: Scopus
Preferred by: Vanora Hundley
Should oral misoprostol be used to prevent postpartum haemorrhage in home-birth settings in low-resource countries? A systematic review of the evidence.
Authors: Hundley, V.A., Avan, B.I., Sullivan, C.J. and Graham, W.J.
Journal: BJOG
Volume: 120
Issue: 3
Pages: 277-285
eISSN: 1471-0528
DOI: 10.1111/1471-0528.12049
Abstract:BACKGROUND: Using misoprostol to prevent postpartum haemorrhage (PPH) in home-birth settings remains controversial. OBJECTIVES: To review the safety and effectiveness of oral misoprostol in preventing PPH in home-birth settings. SEARCH STRATEGY: The Cochrane Library, PubMed, and POPLINE were searched for articles published until 31 March 2012. SELECTION CRITERIA: Studies, conducted in low-resource countries, comparing oral misoprostol with a placebo or no treatment in a home-birth setting. Studies of misoprostol administered by other routes were excluded. DATA COLLECTION AND ANALYSIS: Data were extracted by two reviewers and independently checked for accuracy by a third. The quality of evidence was assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria. Data were sythesised and meta-analysis was performed where appropriate. MAIN RESULTS: Ten papers describing two randomised and four non randomised trials. Administration of misoprostol was associated with a significant reduction in the incidence of PPH (RR 0.58, 95% CI 0.38-0.87), additional uterotonics (RR 0.34, 95% CI 0.16-0.73), and referral for PPH (RR 0.49, 95% CI 0.37-0.66). None of the studies was large enough to detect a difference in maternal mortality, and none reported neonatal mortality. Shivering and pyrexia were the most common side effects. AUTHOR'S CONCLUSIONS: The finding that the distribution of oral misoprostol through frontline health workers is effective in reducing the incidence of PPH could be a significant step forwards in reducing maternal deaths in low-resource countries. However, given the limited number of high-quality studies in this review, further randomised controlled trials are required to confirm the association, particularly in different implementation settings. Adverse effects have not been systematically captured, and there has been limited consideration of the potential for inappropriate or inadvertent use of misoprostol. Further evidence is needed to inform the development of implementation and safety guidelines on the routine availability of misoprostol.
https://eprints.bournemouth.ac.uk/21621/
Source: PubMed
Should oral misoprostol be used to prevent postpartum haemorrhage in home-birth settings in low-resource countries? A systematic review of the evidence
Authors: Hundley, V.A., Avan, B.I., Sullivan, C.J. and Graham, W.J.
Journal: BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY
Volume: 120
Issue: 3
Pages: 277-287
eISSN: 1471-0528
ISSN: 1470-0328
DOI: 10.1111/1471-0528.12049
https://eprints.bournemouth.ac.uk/21621/
Source: Web of Science (Lite)
Should oral misoprostol be used to prevent postpartum haemorrhage in home-birth settings in low-resource countries? A systematic review of the evidence
Authors: Hundley, V., Avan, B.I., Sullivan, C.J. and Graham, W.J.
Journal: BJOG: An International Journal of Obstetrics & Gynaecology
Publisher: BJOG
DOI: 10.1111/1471-0528.12049
Abstract:Background Using misoprostol to prevent postpartum haemorrhage (PPH) in home-birth settings remains controversial.
Objectives To review the safety and effectiveness of oral misoprostol in preventing PPH in home-birth settings.
Search strategy The Cochrane Library, PubMed, and POPLINE were searched for articles published until 31 March 2012.
Selection criteria Studies, conducted in low-resource countries, comparing oral misoprostol with a placebo or no treatment in a home-birth setting. Studies of misoprostol administered by other routes were excluded.
Data collection and analysis Data were extracted by two reviewers and independently checked for accuracy by a third. The quality of evidence was assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria. Data were sythesised and meta-analysis was performed where appropriate.
Main results Ten papers describing two randomised and four non randomised trials. Administration of misoprostol was associated with a significant reduction in the incidence of PPH (RR 0.58, 95% CI 0.38–0.87), additional uterotonics (RR 0.34, 95% CI 0.16–0.73), and referral for PPH (RR 0.49, 95% CI 0.37–0.66). None of the studies was large enough to detect a difference in maternal mortality, and none reported neonatal mortality. Shivering and pyrexia were the most common side effects.
Author’s conclusions The finding that the distribution of oral misoprostol through frontline health workers is effective in reducing the incidence of PPH could be a significant step forwards in reducing maternal deaths in low-resource countries. However, given the limited number of high-quality studies in this review, further randomised controlled trials are required to confirm the association, particularly in different implementation settings. Adverse effects have not been systematically captured, and there has been limited consideration of the potential for inappropriate or inadvertent use of misoprostol. Further evidence is needed to inform the development of implementation and safety guidelines on the routine availability of misoprostol.
https://eprints.bournemouth.ac.uk/21621/
http://onlinelibrary.wiley.com/doi/10.1111/1471-0528.12049/pdf
Source: Manual
Should oral misoprostol be used to prevent postpartum haemorrhage in home-birth settings in low-resource countries? A systematic review of the evidence.
Authors: Hundley, V.A., Avan, B.I., Sullivan, C.J. and Graham, W.J.
Journal: BJOG : an international journal of obstetrics and gynaecology
Volume: 120
Issue: 3
Pages: 277-285
eISSN: 1471-0528
ISSN: 1470-0328
DOI: 10.1111/1471-0528.12049
Abstract:Background
Using misoprostol to prevent postpartum haemorrhage (PPH) in home-birth settings remains controversial.Objectives
To review the safety and effectiveness of oral misoprostol in preventing PPH in home-birth settings.Search strategy
The Cochrane Library, PubMed, and POPLINE were searched for articles published until 31 March 2012.Selection criteria
Studies, conducted in low-resource countries, comparing oral misoprostol with a placebo or no treatment in a home-birth setting. Studies of misoprostol administered by other routes were excluded.Data collection and analysis
Data were extracted by two reviewers and independently checked for accuracy by a third. The quality of evidence was assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria. Data were sythesised and meta-analysis was performed where appropriate.Main results
Ten papers describing two randomised and four non randomised trials. Administration of misoprostol was associated with a significant reduction in the incidence of PPH (RR 0.58, 95% CI 0.38-0.87), additional uterotonics (RR 0.34, 95% CI 0.16-0.73), and referral for PPH (RR 0.49, 95% CI 0.37-0.66). None of the studies was large enough to detect a difference in maternal mortality, and none reported neonatal mortality. Shivering and pyrexia were the most common side effects.Author's conclusions
The finding that the distribution of oral misoprostol through frontline health workers is effective in reducing the incidence of PPH could be a significant step forwards in reducing maternal deaths in low-resource countries. However, given the limited number of high-quality studies in this review, further randomised controlled trials are required to confirm the association, particularly in different implementation settings. Adverse effects have not been systematically captured, and there has been limited consideration of the potential for inappropriate or inadvertent use of misoprostol. Further evidence is needed to inform the development of implementation and safety guidelines on the routine availability of misoprostol.https://eprints.bournemouth.ac.uk/21621/
Source: Europe PubMed Central
Should oral misoprostol be used to prevent postpartum haemorrhage in home-birth settings in low-resource countries? A systematic review of the evidence.
Authors: Hundley, V., Avan, B.I., Sullivan, C. and Graham, W.J.
Journal: BJOG: An International Journal of Obstetrics & Gynaecology
Volume: 120
Issue: 3
Pages: 277-285
ISSN: 1470-0328
Abstract:Using misoprostol to prevent postpartum haemorrhage (PPH) in home-birth settings remains controversial.
https://eprints.bournemouth.ac.uk/21621/
Source: BURO EPrints