Misoprostol to prevent and treat postpartum haemorrhage: a systematic review and meta-analysis of maternal deaths and dose-related effects
G Justus Hofmeyr, A Metin Gülmezoglu, Natalia Novikova, Verena Linder, Sandra Ferreira & Gilda Piaggio
Volume 87, Number 9, September 2009, 666-677
Table 2. Maternal deaths and severe morbidity reported in randomized controlled trials of misoprostol to prevent or treat postpartum haemorrhage
| Studya | Misoprostol group | Control group | ||
|---|---|---|---|---|
| China 2001: 600 PO vs U |
No cases | 1 hysterectomy in multiparous woman with PPH (5 L) due to uterine atony | ||
| China 2004a: 600 PO vs U |
PPH (4 L) due to uterine atony in primiparous woman | No cases | ||
| Gambia 2004 |
No cases | 2 hysterectomies, no details reported | ||
| Gambia 2005 |
1 maternal death from PPH (2.2 L) in gravida 7, para 6, delivered at home | 1 hospital admission for PPH and clinical anaemia | ||
| 1 maternal death from disseminated intravascular coagulation due to malaria | 2 hospital admissions for severe postpartum anaemia | |||
| 2 hospital admissions from severe postpartum anaemia | ||||
| Guinea-Bissau 2005 |
1 maternal death, PPH (1.4 L), cause of death not established on autopsy | No cases | ||
| India 2006c |
2 ICU admissions | 2 ICU admissions | ||
| South Africa 2001a |
1 case of fever > 40 °C | No cases | ||
| South Africa 2001b |
1 internal iliac artery ligation for severe PPH | 1 hysterectomy for severe PPH | ||
| South Africa 2004 |
1 maternal death from severe PPH, coagulopathy, had hysterectomy, died on day 2 postpartum | No cases | ||
| 1 maternal death from severe PPH (3 L) secondary to cervical tear, coagulopathy | ||||
| 1 maternal death from PPH (1 L), hypotension and cardiac arrest, possibly had internal bleeding from dehisced Caesarean section scar | ||||
| 2 hysterectomies for PPH | ||||
| WHO 2001 |
2 maternal deaths | 2 maternal deaths | ||
| 4 hysterectomies | 8 hysterectomies | |||
| 4 ICU admissions | 5 ICU admissions | |||
| 5 cases of fever > 40 °C |
ICU, intensive care unit; IV, intravascular; PPH, postpartum haemorrhage.
a The format used for study identifiers was as follows: country, year, misoprostol (M) dose in micrograms (µ), route of administration (IM = intramuscular; IV = intravenous; PO = oral; PR = rectal; SL = sublingual), misoprostol compared with (vs) placebo (P) or another uterotonic (U).