Trial reportGlobal health action2011
Oral misoprostol for preventing postpartum haemorrhage in home births in rural Bangladesh: how effective is it?
Trial report in Global health action, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 3 of them syntheses that pooled 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.
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.
Who cites it
16 citing papers in PubMed, 3 syntheses or guidelines pooled it, 38 citations in OpenAlex.
- Task shifting in active management of the third stage of labor: a systematic review.BMC pregnancy and childbirth · 2018Pooled it
- Prevention of postpartum haemorrhage: cost consequences analysis of misoprostol in low-resource settings.BMC pregnancy and childbirth · 2015Pooled it
- Which intervention design factors influence performance of community health workers in low- and middle-income countries? A systematic review.Health policy and planning · 2015Pooled it
- Effectiveness and safety of misoprostol distributed to antenatal women to prevent postpartum haemorrhage after child-births: a stepped-wedge cluster-randomized trial.BMC pregnancy and childbirth · 2015Trial
- Randomised Controlled Trial of Sublingual and Rectal Misoprostol in the Prevention of Primary Postpartum Haemorrhage in a Resource-Limited Community.Journal of obstetrics and gynaecology of India · 2020Article
- Cost-effectiveness of inhaled oxytocin for prevention of postpartum haemorrhage: a modelling study applied to two high burden settings.BMC medicine · 2020Article
- Article
- An exploration of village-level uterotonic practices in Fenerive-Est, Madagascar.BMC pregnancy and childbirth · 2016Article
- A New Look at Care in Pregnancy: Simple, Effective Interventions for Neglected Populations.PloS one · 2016Review
- How does context influence performance of community health workers in low- and middle-income countries? Evidence from the literature.Health research policy and systems · 2015Article
- Modeling maternal mortality in Bangladesh: the role of misoprostol in postpartum hemorrhage prevention.BMC pregnancy and childbirth · 2014Article
- Is attendant at delivery associated with the use of interventions to prevent postpartum hemorrhage at home births? The case of Bangladesh.BMC pregnancy and childbirth · 2014Article
- Women's health in women's hands: a pilot study assessing the feasibility of providing women with medications to reduce postpartum hemorrhage and sepsis in rural Tanzania.Health care for women international · 2014Article
- "Can community level interventions have an impact on equity and utilization of maternal health care" - evidence from rural Bangladesh.International journal for equity in health · 2013Article
- Misoprostol for postpartum hemorrhage prevention at home birth: an integrative review of global implementation experience to date.BMC pregnancy and childbirth · 2013Review
- Prevention of postpartum hemorrhage in low-resource settings: current perspectives.International journal of women's health · 2013Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsEvidence exists about prevention of postpartum haemorrhage (PPH) by oral administration of misoprostol in low-income countries, but effectiveness of prevention by lay community health workers (CHW) is not sufficient. This study aimed to investigate whether a single dose (400 µg) of oral misoprostol could prevent PPH in a community home-birth setting and to assess its acceptability and feasibility among rural Bangladeshi women.
methodsThis quasi-experimental trial was conducted among 2,017 rural women who had home deliveries between November 2009 and February 2010 in two rural districts of northern Bangladesh. In the intervention district 1,009 women received 400 µg of misoprostol immediately after giving birth by the lay CHWs, and in the control district 1,008 women were followed after giving birth with no specific intervention against PPH. Primary PPH (within 24 hours) was measured by women's self-reported subjective measures of the normality of blood loss using the 'cultural consensus model.' Baseline data provided socio-economic, reproductive, obstetric, and bleeding disorder information.
findingsThe incidence of primary PPH was found to be lower in the intervention group (1.6%) than the control group (6.2%) (p<0.001). Misoprostol provided 81% protection (RR: 0.19; 95% CI: 0.08-0.48) against developing primary PPH. The proportion of retained and manually removed placentae was found to be higher in the control group compared to the intervention group. Women in the control group were more likely to need an emergency referral to a higher level facility and blood transfusion than the intervention group. Unexpectedly few women experienced transient side effects of misoprostol. Eighty-seven percent of the women were willing to use the drug in future pregnancy and would recommend to other pregnant women.
conclusionCommunity-based distribution of oral misoprostol (400 µg) by CHW appeared to be effective, safe, acceptable, and feasible in reducing the incidence of PPH in rural areas of Bangladesh. This strategy should be scaled up across the country where access to skilled attendance is limited.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.