| What measured blood loss tells us about postpartum bleeding: a systematic review. | |
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MedLine Citation:
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PMID: 20406227 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Meta-analyses of postpartum blood loss and the effect of uterotonics are biased by visually estimated blood loss. OBJECTIVES: To conduct a systematic review of measured postpartum blood loss with and without prophylactic uterotonics for prevention of postpartum haemorrhage (PPH). SEARCH STRATEGY: We searched Medline and PubMed terms (labour stage, third) AND (ergonovine, ergonovine tartrate, methylergonovine, oxytocin, oxytocics or misoprostol) AND (postpartum haemorrhage or haemorrhage) and Cochrane reviews without any language restriction. SELECTION CRITERIA: Refereed publications in the period 1988-2007 reporting mean postpartum blood loss, PPH (> or =500 ml) or severe PPH (> or =1000 ml) following vaginal births. DATA COLLECTION AND ANALYSIS: Raw data were abstracted into Excel by one author and then reviewed by a co-author. Data were transferred to SPSS 17.0, and copied into RevMan 5.0 to perform random effects meta-analysis. MAIN RESULTS: The distribution of average blood loss (29 studies) is similar with any prophylactic uterotonic, and is lower than without prophylaxis. Compared with no uterotonic, oxytocin and misoprostol have lower PPH (OR 0.43, 95% CI 0.23-0.81; OR 0.73, 95% CI 0.50-1.08, respectively) and severe PPH rates (OR 0.61, 95% CI 0.29-1.29; OR 0.74, 95% CI 0.52-1.04, respectively). Oxytocin has lower PPH (OR 0.65, 95% CI 0.60-0.70) and severe PPH (OR 0.71, 95% CI 0.56-0.91) rates than misoprostol, but not in developing countries. CONCLUSION: Oxytocin is superior to misoprostol in hospitals. Misoprostol substantially lowers PPH and severe PPH. A sound assessment of the relative merits of the two drugs is needed in rural areas of developing countries, where most PPH deaths occur. |
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Authors:
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N L Sloan; J Durocher; T Aldrich; J Blum; B Winikoff |
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Publication Detail:
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Type: Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't; Review Date: 2010-04-20 |
Journal Detail:
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Title: BJOG : an international journal of obstetrics and gynaecology Volume: 117 ISSN: 1471-0528 ISO Abbreviation: BJOG Publication Date: 2010 Jun |
Date Detail:
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Created Date: 2010-05-20 Completed Date: 2010-08-17 Revised Date: 2010-09-30 |
Medline Journal Info:
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Nlm Unique ID: 100935741 Medline TA: BJOG Country: England |
Other Details:
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Languages: eng Pagination: 788-800 Citation Subset: AIM; IM |
Affiliation:
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Gynuity Health Projects, New York, NY, USA. nlsloan@gmail.com |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Female Humans Labor Stage, Third Oxytocics* Postpartum Hemorrhage / diagnosis, prevention & control* Pregnancy Randomized Controlled Trials as Topic Specimen Handling |
| Chemical | |
Reg. No./Substance:
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0/Oxytocics |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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