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Misoprostol in the Treatment of Postpartum Hemorrhage

Not Applicable
Completed
Conditions
Postpartum Hemorrhage
Interventions
Registration Number
NCT00116480
Lead Sponsor
Gynuity Health Projects
Brief Summary

Postpartum haemorrhage (PPH) remains a leading cause of maternal mortality, despite treatment with conventional methods. Uncontrolled reports and three small randomised controlled trials have suggested that misoprostol may have an additive effect to routine treatment, and there is a serious danger that this method will be used widely without research to document the effectiveness or risks of this method. In this randomised controlled trial (RCT), we propose to test whether 600 μg of sublingually administered misoprostol in women requiring additional uterotonics after delivery, and after routine syntocinon to all women during or after delivery, has additional effects above the additional conventional uterotonics in reducing PPH. Women with measured blood loss greater than or equal to 500 mls in 4 Karachi hospitals who give consent will be given locally routine treatment for PPH. In addition, they will be enrolled by drawing the next of a series of randomised treatment packs containing misoprostol or placebo. The primary outcome measure will be blood loss greater than or equal to 500 mls after enrolment.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
Female
Target Recruitment
61
Inclusion Criteria
  • All women delivering vaginally with clinically diagnosed PPH requiring uterotonics
Exclusion Criteria
  • Refusal to give consent for participation or if the woman is too distressed to give consent
  • Woman is not entitled to give informed consent (e.g. minors without a guardian)
  • Woman who had a caesarean section
  • Delivery is regarded as abortion (gestational age < 28 weeks)

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
PlaceboMisoprostolthree tablets resembling misoprostol given sublingually
MisoprostolMisoprostolthree tablets of active misoprostol (600 mcg) given sublingually
Primary Outcome Measures
NameTimeMethod
Blood loss greater than or equal to 500 mls after enrolmentBlood loss measured for minimum of 1 hour or until active bleeding ceased
Secondary Outcome Measures
NameTimeMethod
Pre-delivery and post-delivery hemoglobin measuresPre-delivery hemoglobin measured upon admission to hospital (during labor) and measured postpartum 12-24 hours after delivery
Side effectsobserved or reported following study treatment and prior to discharge
Average blood lossBlood loss measured for minimum of one hour or until active bleeding ceased
Clinical complications (need for transfusion, hysterectomy)After delivery and prior to hospital discharge

Trial Locations

Locations (2)

The Aga Khan Health Services

🇵🇰

Karachi, Pakistan

Aga Khan University Hospital

🇵🇰

Karachi, Pakistan

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