Thesis (MCur)--Stellenbosch University, 2011. / ENGLISH ABSTRACT: Background: Misoprostol, a prostaglandin E1 analogue with its uterotonic properties
has entered as an integral part of management of the third stage of labour, helping to
prevent postpartum haemorrhage (PPH).
Objective: To assess evidence on the effectiveness of misoprostol compared to a
placebo for the prevention and treatment of postpartum haemorrhage.
Methods: Databases searched included; MEDLINE, Google Scholar and Cochrane
Central Register of Controlled Trials (CENTRAL). Other sources were also searched.
All articles were screened for methodological quality by two reviewers independently by
standardized instrument. Data was entered in Review Manger 5.1 software for analysis.
Results: Three Misoprostol studies were included (2346 participants), Oral (2 trials) and
sublingual (1 trial). Misoprostol has shown not to be effective in reducing PPH (RR
0.65: 95% CI 0.40-1.06). Only one trial reported on need for blood transfusion (RR
0.14; 95% CI 0.02-1.15). Misoprostol use is associated with significant increases in
shivering (RR 2.75; 95% CI 2.26-3.34) and pyrexia (RR 5.34; 95% CI 2.86-9.96) than
with placebo. No maternal deaths were reported in included trials. Compared to
placebo, misoprostol was coupled with less hysterectomies and additional used of
uterotonics (RR 0.45; 95%CI 0.21-0.96) compared to placebo.
Conclusion: Results of this review shows that the use of misoprostol in combination
with some components of active management was not associated with any significant
reduction in incidence of PPH. However oral administration showed a significant
reduction in incidence of PPH. For its use for treatment of postpartum haemorrhage,
there is a need for research focus in optimal dose and route of administration for a
clinically significant effect and acceptable side effects. / AFRIKAANSE OPSOMMING: Agtergrond: Misoprostol, 'n prostaglandien E1 analoog met sy uterotonic eienskappe
het ingeskryf as' n integrale deel van die bestuur van die derde stadium van kraam, help
postpartum bloeding (PPH) te voorkom.
Doelwit: Om bewyse oor die effektiwiteit van Misoprostol in vergelyking met 'n placebo
vir die voorkoming en behandeling van postpartum bloeding te evalueer.
Metodes: Databases gesoek ingesluit, Medline, CINHAL, Google Scholar en Cochrane
Sentrale Register van gecontroleerde studies (Sentraal). Ander bronne is ook
deursoek. Alle artikels is gekeur vir die metodologiese kwaliteit deur twee beoordelaars
onafhanklik deur die gestandaardiseerde instrument. Data is opgeneem in Review
Manger 5.1 sagteware vir ontleding.
Hoof Resultate: Drie Misoprostol studies were ingesluit (2346 deelnemers). Mondeling
(2 proe) en sublinguale (1 verhoor). Misoprostol het getoon nie doeltreffend te wees in
die vermindering van PPH (RR 0,65: 95% CI 0,40-1,06). Slegs een verhoor berig oor
die noodsaaklikheid vir 'n bloedoortapping (RR 0,14, 95% CI 0,02-1,15). Misoprostol
gebruik word geassosieer met 'n aansienlike toename in bewing (RR 2,75, 95% CI 2,26-
3,34) en koors (RR 5,34, 95% CI 2,86-9,96) as met' n placebo. Geen moederlike
sterftes is aangemeld in proewe. In vergelyking met placebo, was Misoprostol tesame
met minder hysterectomies en addisionele gebruik van uterotonics (RR 0,45, 95%
CI,21-,96) in vergelyking met placebo.
Gevolgtrekking: Resultate van hierdie studie toon dat die gebruik van Misoprostol in
kombinasie met 'n paar komponente van aktiewe bestuur is wat nie verband hou met' n
beduidende afname in die voorkoms van PPH. Vir die gebruik vir die behandeling van
postpartum bloeding, daar is 'n behoefte vir navorsing fokus in die optimale dosis en die
roete van administrasie vir' n klinies beduidende uitwerking en aanvaarbare neweeffekte.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:sun/oai:scholar.sun.ac.za:10019.1/17900 |
| Date | 12 1900 |
| Creators | Olefile, Kabelo Monicah |
| Contributors | Khondowe, Oswell, M’Rithaa, Doreen K. M., Stellenbosch University. Faculty of Health Science. Dept. of Interdisciplinary Health Sciences. Nursing Science. |
| Publisher | Stellenbosch : Stellenbosch University |
| Source Sets | South African National ETD Portal |
| Language | en_ZA |
| Detected Language | English |
| Type | Thesis |
| Format | 63 p. |
| Rights | Stellenbosch University |
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