Misoprostol in the management of the third stage of labour in the home delivery setting in rural Gambia: A randomised controlled trial
Objective: To assess the effectiveness of 600 μg oral misoprostol on postpartum haemorrhage (PPH) and postpartum anaemia in a low income country home birth situation. Design: Double blind randomised controlled trial. Setting: Twenty-six villages in rural Gambia with 52 traditional birth attendants (TBAs). Sample: One thousand, two hundred and twenty-nine women delivering at home under the guidance of a trained TBA. Methods: Active management of the third stage of labour using three 200-μg misoprostol tablets and placebo or four 0.5-mg ergometrine tablets (standard treatment) and placebo. Tablets were taken orally immediately after delivery. Main outcome measures: Measured blood loss, postpartum haemoglobin (Hb), difference between Hb at the last antenatal care visit and three to five days postpartum. Results: The misoprostol group experienced lower incidence of measured blood loss ≥500 mL and postpartum HbConclusions: Six hundred micrograms of oral misoprostol is a promising drug to prevent life-threatening PPH in this setting.
Walraven, Gijs, Jennifer Blum, Yusupha Dampha, Maimuna Sowe, Linda A. Morison, Beverly Winikoff, and Nancy L. Sloan. 2005. "Misoprostol in the management of the third stage of labour in the home delivery setting in rural Gambia: A randomized trial," BJOG: An International Journal of Obstetrics and Gynaecology 112(9): 1277–1283.