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Misoprostol Doesn't Cut Risk of Postpartum Hemorrhage

Misoprostol administered immediately after delivery also linked to more maternal adverse events

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TUESDAY, Sept. 20, 2016 (HealthDay News) -- For women in the third stage of labor, misoprostol administered with routine oxytocin does not reduce the rate of postpartum hemorrhage, according to a study published online Sept. 5 in Obstetrics & Gynecology.

Thibaud Quibel, M.D., from Poissy-Saint Germain Hospital in France, and colleagues conducted a randomized trial involving women in the first stage of labor with expected vaginal deliveries at 36 to 42 weeks of gestation. Participants received routine oxytocin and were randomized to misoprostol or placebo immediately after delivery.

After the planned interim analysis including 1,721 patients showed that misoprostol was not effective and was associated with more adverse effects, the study was discontinued. The researchers found that the rates of postpartum hemorrhage were 8.4 and 8.3 percent in the misoprostol and placebo groups, respectively (P = 0.98); severe postpartum hemorrhage rates were 1.8 and 2.4 percent, respectively (P = 0.57). Patients in the misoprostol group had maternal adverse events more frequently (fever and shivering, both P < 0.001).

"Misoprostol administered with prophylactic routine oxytocin did not reduce the rate of postpartum hemorrhage risk and increased the rate of adverse events," the authors write.

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