Evidence map›Paper›PMID 21176086›Full record

Trial reportBJOG : an international journal of obstetrics and gynaecology2011

Administration of misoprostol by trained traditional birth attendants to prevent postpartum haemorrhage in homebirths in Pakistan: a randomised placebo-controlled trial.

N Mobeen, J Durocher, Nf Zuberi, N Jahan, J Blum, S Wasim, G Walraven, J Hatcher

Open access · bronzeAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BJOG : an international journal of obstetrics and gynaecology, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 59 papers, 15 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
59citing papers in PubMed, 15 pooled it
17.8field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

59 citing papers in PubMed, 15 syntheses or guidelines pooled it, 136 citations in OpenAlex.

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  12. Treatment for primary postpartum haemorrhage.The Cochrane database of systematic reviews · 2014
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  13. Postpartum misoprostol for preventing maternal mortality and morbidity.The Cochrane database of systematic reviews · 2013
    Pooled it
  14. Prostaglandins for preventing postpartum haemorrhage.The Cochrane database of systematic reviews · 2012
    Pooled it
  15. Carbetocin for preventing postpartum haemorrhage.The Cochrane database of systematic reviews · 2012
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors at 2 institutions in 2 countries.

N MobeenDepartment of Community Health Sciences, Aga Khan University, Karachi, Pakistan Gynuity Health Projects, New York, NY, USA.
J Durocher
Nf Zuberi
N Jahan
J Blum
S Wasim
G Walraven
J Hatcher
Aga Khan University · PKGynuity Health Projects · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveto determine if misoprostol is safe and efficacious in preventing postpartum haemorrhage (PPH) when administered by trained traditional birth attendants (TBA) at home deliveries.

designa randomised, double-blind, placebo-controlled trial.

settingChitral, Khyber Pakhtunkhwa Province, Pakistan. POPULATION: a total of 1119 women giving birth at home.

methodsfrom June 2006 to June 2008, consenting women were randomised to receive 600 microg oral misoprostol (n = 534) or placebo (n = 585) after delivery to determine whether misoprostol reduced the incidence of PPH (≥ 500 ml).

main outcome measuresthe primary outcomes were measured blood loss ≥ 500 ml after delivery and drop in haemoglobin >2 g/dl from before to after delivery.

resultsoral misoprostol was associated with a significant reduction in the rate of PPH (≥ 500 ml) (16.5 versus 21.9%; relative risk 0.76, 95% CI 0.59-0.97). There were no measurable differences between study groups for drop in haemoglobin >2 g/dl (relative risk 0.79, 95% CI 0.62-1.02); but significantly fewer women receiving misoprostol had a drop in haemoglobin >3 g/dl, compared with placebo (5.1 versus 9.6%; relative risk 0.53, 95% CI 0.34-0.83). Shivering and chills were significantly more common with misoprostol. There were no maternal deaths among participants.

conclusionspostpartum administration of 600 microg oral misoprostol by trained TBAs at home deliveries reduces the rate of PPH by 24%. Given its ease of use and low cost, misoprostol could reduce the burden of PPH in community settings where universal oxytocin prophylaxis is not feasible. Continual training and skill-building for TBAs, along with monitoring and evaluation of programme effectiveness, should accompany any widespread introduction of this drug.

Indexed as

Home ChildbirthMidwiferyMisoprostolOxytocicsAdministration, OralAdultDouble-Blind MethodFemaleHumansPakistanPostpartum HemorrhagePregnancyTreatment OutcomeMisoprostolOxytocics

Identifiers

PMID21176086
PMCPMC3041931
OpenAlexW2113504190

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.