- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT00107874
Oral Misoprostol Versus Intravenous Oxytocin in Preventing Blood Loss After Non-scheduled Cesarean Section
Oral Misoprostol as a Second-line Alternative to Intravenous Oxytocin in Preventing Postoperative Blood Loss After Non-scheduled Cesarean Section: a Randomized, Double-blind, Placebo-controlled Trial
Postpartum hemorrhage (PPH) ranks among the leading causes of maternal morbidity and mortality, both in developed and developing countries.
With this trial, we sought to determine the effectiveness of oral misoprostol as an uterotonic drug in comparison with intravenous oxytocin, in patients with a low risk of PPH undergoing non-scheduled Cesarean section.
We therefore compared the intra- and postoperative blood loss, as well as drug related side effects in patients, treated by the same surgical and anesthesiological team in one institution.
Study Overview
Detailed Description
Postpartum hemorrhage (PPH) is still among the leading causes of maternal morbidity and mortality. The incidence of PPH is reduced by active management of the third stage of labor which includes the use of uterotonics for pharmacological prophylaxis. However, there is an on-going debate about the optimal drug selection since uterotonics such as oxytocin and methylergometrine are liable for specific side effects and complications when administered within a dose range needed to be effective for PPH. In the search for an alternative to these conventional standard uterotonics, misoprostol (prostaglandin E1) has turned out to be an effective therapeutic option and has been implemented in actual treatment regimens. The objective of this study was to compare the effectiveness of oral applicated misoprostol versus intravenous oxytocin in reducing blood loss in low risk obstetric patients undergoing non-scheduled cesarean section (CS) under spinal anesthesia.
Comparison:
In this prospective, double blind study, parturients undergoing CS were randomized to receive either a) oral misoprostol and an infusion of normal saline supplemented with placebo, or b) an oral placebo and an infusion of normal saline, supplemented with oxytocin subsequently to intravenous oxytocin after cord clamping in both groups.
The primary outcomes were the amount of intra- and postoperative blood loss and the occurrence of drug-related side effects.
Study Type
Enrollment (Actual)
Phase
- Phase 2
Contacts and Locations
Study Locations
-
-
-
Basel, Switzerland, 4031
- Women's University Hospital, Basel
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Non-scheduled primary or secondary Cesarean section (CS) after the 37th week of gestation
Exclusion Criteria:
- Emergency CS
- Fetal distress
- Fetal malformations
- Preeclampsia and HELLP (Hemolysis-Elevated Liver enzymes-Low Platelet count syndrome)
- Hypersensitivity to prostaglandins
- Coagulopathy
- Severe systemic disorders
- An American Society of Anesthesiologists (ASA) physical status >/= 3
- Severe asthma
- Prior myomectomy
- Maternal fever (> 38.5 °C)
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
---|
Reduction of postpartum hemorrhage
|
Secondary Outcome Measures
Outcome Measure |
---|
Blood loss
|
medicamentous side effects
|
efficacy of medicaments
|
Collaborators and Investigators
Investigators
- Study Chair: Irène Hösli, Prof. Dr. MD, University Hospital, Basel, Switzerland
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Pathologic Processes
- Pregnancy Complications
- Obstetric Labor Complications
- Puerperal Disorders
- Uterine Hemorrhage
- Hemorrhage
- Postpartum Hemorrhage
- Physiological Effects of Drugs
- Gastrointestinal Agents
- Reproductive Control Agents
- Anti-Ulcer Agents
- Abortifacient Agents, Nonsteroidal
- Abortifacient Agents
- Oxytocics
- Misoprostol
Other Study ID Numbers
- M73/99
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on Postpartum Hemorrhage
-
Assistance Publique - Hôpitaux de ParisInstitut National de la Santé Et de la Recherche Médicale, FranceCompletedPostpartum Haemorrhage | Immediate Postpartum HemorrhageFrance
-
University Hospital, Clermont-FerrandUnknownPostpartum Depression | Postpartum Hemorrhage | Postpartum Women | Postpartum Stress | Postpartum AnxietyFrance
-
ResQ Medical LtdNot yet recruitingPPH | Postpartum Hemorrhage \(PPH\) | Postpartum Hemorrhage \(Primary\)Kenya
-
Cairo UniversityUnknownHemorrhage, PostpartumEgypt
-
Columbia UniversityCompletedHemorrhage, PostpartumUnited States
-
Ain Shams Maternity HospitalUnknownHemorrhage PostpartumEgypt
-
Chelsea and Westminster NHS Foundation TrustCompleted
-
Megan LordThermaSENSE CorpCompletedHemorrhage | Vasoconstriction | Hemorrhage, PostpartumUnited States
-
Assistance Publique - Hôpitaux de ParisInstitut National de la Santé Et de la Recherche Médicale, FranceCompletedImmediate Postpartum HemorrhageFrance
-
Gynuity Health ProjectsAga Khan Health ServicesCompletedPostpartum Hemorrhage (PPH)Afghanistan
Clinical Trials on misoprostol
-
Aljazeera HospitalKasr El Aini HospitalUnknown
-
Hospital de Clinicas de Porto AlegreCompletedMiscarriage in First TrimesterBrazil
-
Cairo UniversityCompleted
-
Ferring PharmaceuticalsCompletedCervical Ripening | Labor InductionUnited Kingdom
-
Medstar Health Research InstituteSociety of Family PlanningCompletedSecond Trimester AbortionsUnited States
-
Karolinska InstitutetCompletedFirst Trimester Pregnancy | Surgical Termination of PregnancySweden
-
CHA UniversityCompleted
-
Wenzhou Medical UniversityUnknown
-
University of Texas Southwestern Medical CenterCompleted
-
Rajavithi HospitalCompletedTo Compare Efficacy Intrauterine vs Sublingual MISOPROSTOL in Addition to Oxytocin in Reducing Blood Loss of Post-cesarean Section in High Risk WomenThailand