ArticleBMC pregnancy and childbirth2012
Dose and side effects of sublingual misoprostol for treatment of postpartum hemorrhage: what difference do they make?
Article in BMC pregnancy and childbirth, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01080846 (Assessment of Fever After Misoprostol Administration for the Treatment of Primary Postpartum Hemorrhage), which is not on this map. Cited by 6 papers, 1 of them a synthesis that pooled it.
What it found
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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.
Assessment of Fever After Misoprostol Administration for the Treatment of Primary Postpartum Hemorrhage
Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it, 19 citations in OpenAlex.
- What do healthcare providers think of the quality of uterotonics? A mixed-methods systematic review.BMJ open · 2023Pooled it
- Hyperpyrexia with hemodynamic instability after sublingual misoprostol: case report and literature review.AJOG global reports · 2026Article
- Misoprostol-Induced Fever and Unnecessary Antibiotic Prescribing: A Retrospective Study.Infectious diseases and therapy · 2023Article
- Relationship between Maternal Fever and Neonatal Sepsis: A Retrospective Study at a Medical Center.Biomedicines · 2022Article
- High fever after sublingual administration of misoprostol for treatment of post-partum haemorrhage: a hospital-based, prospective observational study in Argentina.Tropical medicine & international health : TM & IH · 2020Observational
- Sublingual misoprostol and hyperpyrexia: case report with temperature curve.BMC research notes · 2017Article
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 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundShivering and fever are common side effects of misoprostol. An unexpectedly high rate of fever above 40°C was documented among Ecuadorian women given treatment with 800mcg of sublingual misoprostol to manage postpartum hemorrhage (PPH) (36%). Much lower rates have been reported elsewhere (0-9%).
methodsFrom February to July 2010, an open-label pilot study was conducted in Quito, Ecuador to determine whether a lower dose--600mcg sublingual misoprostol--would result in a lower incidence of high fever (≥40°C). Rates of shivering and fever with 600mcg sublingual regimen were compared to previously documented rates in Ecuador following PPH treatment with 800mcg sublingual misoprostol.
resultsThe 600mcg dose resulted in a 55% lower rate of high fever compared with the 800mcg regimen (8/50; 16% vs. 58/163; 36%; relative risk 0.45 95% CI 0.23-0.88). Only one woman had severe shivering following the 600mcg dose compared with 19 women in the 800mcg cohort (2% vs. 12%; relative risk 0.17 (0.02-1.25)). No cases of delirium/altered sensorium were reported with the 600mcg dose and women's assessment of severity/tolerability of shivering and fever was better with the lower dose.
conclusions600mcg sublingual misoprostol was found to decrease the occurrence of high fever among Ecuadorian women when given to treat PPH. This study however was not powered to examine the efficacy of this treatment regimen and cannot be recommended at this time. Future research is needed to confirm whether other populations, outside of Quito, Ecuador, experience unusually high rates of elevated body temperature following sublingual administration of misoprostol for treatment of PPH. If indeed similar trends are found elsewhere, larger trials to confirm the efficacy of lower dosages may be justified.
trial registrationClinical trials.gov, Registry No. NCT01080846.
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