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Title: The use of misoprostol in the active management of the third stage of labour
Keywords: prophylaxis, postpartum haemorrhage, oxytocics, route, uterine activity, side effects
Issue Date: 11-Sep-2006
Citation: CHONG YAP SENG (2006-09-11). The use of misoprostol in the active management of the third stage of labour. ScholarBank@NUS Repository.
Abstract: My hypothesis is that misoprostol, given in the correct dose and route, should produce a uterotonic effect similar to conventional oxytocics used for preventing postpartum haemorrhage. I used intrauterine pressure transducers to measure postpartum uterotonic activity rather than blood loss measurements, which are notoriously imprecise. I identified that the dose and route of misoprostol that provided the fastest, greatest uterotonic effect was an oral solution of 400 A?g misoprostol. I discovered, and was the first to report, that high doses of misoprostol given after delivery is associated with side effects of shivering and fever that limit its safety in clinical use. I performed a systematic review of the literature and concluded that misoprostol was less effective than conventional oxytocics and had significantly more side effects. I recommend that low doses of oral solution misoprostol would be the best and safest way to use misoprostol for managing or preventing postpartum haemorrhage.
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