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Misoprostol for Primary Versus Secondary Prevention of postpartum Haemorrhage: A Cluster-Randomised Non-Inferiority Community Trial

This article describes a cluster-randomized community trial showing ‘secondary prevention’ —a novel approach to PPH management whereby only women who bleed more than average after delivery are given a preemptive treatment dose of misoprostol— to be non-inferior to ‘universal prophylaxis’. The study concludes that this early treatment approach could be a good alternative to universal prophylaxis as it medicates fewer women and is an acceptable and feasible strategy at the community level.

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