New Evidence for Misoprostol for PPH Treatment

Gynuity Health Projects has undertaken a significant body of work to evaluate misoprostol for the treatment of postpartum hemorrhage (PPH). In collaboration with partners in five countries (Burkina Faso, Ecuador, Egypt, Turkey and Vietnam), Gynuity conducted two large clinical trials to evaluate the safety, efficacy, and acceptability of sublingual misoprostol to treat PPH. The studies compared misoprostol to oxytocin, the international standard of care for treating PPH, using a randomized double-blind placebo-controlled study design. One study was conducted at hospitals where women routinely received oxytocin in the third stage of labor. The other study was conducted in hospitals where women did not receive oxytocin before or during the third stage of labor. The results of these studies demonstrated that:

• Sublingual misoprostol (800 mcg) is a safe, effective and acceptable alternative first-line treatment for PPH due to uterine atony.

• Misoprostol is easy to administer and may be particularly useful in settings where administration of IV oxytocin is not possible, particularly at lower levels of the health care system.

The full results for both trials were published in the January 16th edition of The Lancet.