Randomized double-blind placebo-controlled trial of buccal misoprostol to reduce the need for additional uterotonic drugs during cesarean delivery

Abstract Objective To determine whether buccal misoprostol during cesarean delivery in conjunction with active management of the third stage of labor reduces the need for additional uterotonic drugs. Method A double-blind, randomized, placebo-controlled trial was performed in Monterrey, Mexico, betw...

Full description

Saved in:
Bibliographic Details
Published in:International journal of gynecology and obstetrics 2016-02, Vol.132 (2), p.184-187
Main Authors: Hernández-Castro, Flavio, López-Serna, Norberto, Treviño-Salinas, Emilio M, Soria-López, Juan A, Sordia-Hernández, Luis H, Cárdenas-Estrada, Eloy
Format: Article
Language:English
Subjects:
Administration, Buccal
Adult
Buccal administration
Cesarean Section - adverse effects
Cesarean Section - methods
Double-Blind Method
Female
Humans
Infusions, Intravenous
Labor, Obstetric
Mexico
Misoprostol
Misoprostol - administration & dosage
Obstetric hemorrhage
Obstetrics and Gynecology
Oxytocics - administration & dosage
Oxytocin - administration & dosage
Postpartum Hemorrhage - drug therapy
Postpartum Hemorrhage - prevention & control
Pregnancy
Uterine Inertia - drug therapy
Uterine Inertia - surgery
Young Adult
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Abstract Objective To determine whether buccal misoprostol during cesarean delivery in conjunction with active management of the third stage of labor reduces the need for additional uterotonic drugs. Method A double-blind, randomized, placebo-controlled trial was performed in Monterrey, Mexico, between February 2008 and December 2013. Eligible women had risk factors for uterine atony and were to undergo cesarean delivery under epidural block. Using a computer-generated sequence and blocks of six, patients were randomly assigned to receive 400 μg misoprostol or 800 μg placebo buccally after cord clamping. Both groups received an intravenous oxytocin infusion. The primary outcome was the need for additional uterotonic drugs. Analyses were performed per protocol. Patients, investigators, and data analysts were masked to group assignment. Results A total of 120 women were included in analyses (60 in each group). At least one additional uterotonic drug was required in 24 (40%) women in the placebo group versus 6 (10%) women in the misoprostol group (relative risk 0.16; 95% confidence interval 0.06-0.44). No adverse effects due to misoprostol were recorded. Conclusion Buccal misoprostol during cesarean delivery reduced the need for additional uterotonic drugs to treat uterine atony. ClinicalTrials.gov: NCT01733329
ISSN:0020-7292
1879-3479
DOI:10.1016/j.ijgo.2015.06.060