Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology
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This paper presents the results of postal survey of protocols for induction of labour. The drug regimes used for the induction of labour in NHS hospitals in England and Wales have been compared to both RCOG guidelines and to the drug manufacturer's recommendations. A wide variation in practice was found, with many units using dosages that are different from those recommended. The implications of such departures from the norm are discussed in terms of the importance of evidence-based practice and the role of national guidelines in ensuring optimum care.
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Randomized Controlled Trial Comparative Study Clinical Trial
A randomised controlled trial of misoprostol versus oxytocin in the active management of the third stage of labour.
Our objective was to compare oral misoprostol with intramuscular oxytocin in the prevention of postpartum haemorrhage. Four hundred and ninety-six women were randomised to receive either 600 microg misoprostol orally or 10 IU oxytocin intramuscularly after delivery. ⋯ Shivering was significantly higher with misoprostol (57% vs. 14%; RR 4.06, CI 2.93-5.62), but there were no differences in other side effects. We conclude that oral misoprostol can replace intramuscular oxytocin in reducing postpartum haemorrhage in low-risk women, in developing countries, especially as it is administered orally and it is thermostable in tropical conditions.
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Postpartum haemorrhage (PPH) is the leading cause of maternal death worldwide. In the developing countries, it is responsible for the death of about 125 000 women each year. ⋯ This article focuses on the prevention and management of primary PPH and highlights recent developments. Relevant current literature using the MEDLINE search strategy was examined.