Postpartum bleeding is reduced with sublingual powdered misoprostol when compared with oxytocin injection, but a new formulation of misoprostol is unlikely to revolutionise postpartum haemorrhage care.
This commentary responds to the findings of a study that compared powered sublingual misoprostol with oxytocin injection for prevention of postpartum haemorrhage. The study authors reported a lower rate of PPH with the misoprostol than with the oxytocin and called for research using sublingual misoprostol tablets. Winikoff and Durocher present contradictory evidence from a large body of literature and suggest that given the unusually high rate of PPH and bleeding with the oxytocin, the quality of the oxytocin may have been subpar. Of greater benefit would be to focus on integrating these two drugs (with already established formulations) as appropriate, particularly in low-resource settings.
Access the abstract of this article at Evid Based Med. 2013;18(4):143-4.