Navigation Links
No evidence that drug used for preventing life-threatening bleeding in women during labor works
Date:8/20/2012

There is insufficient evidence for the effectiveness of a drug that is being used increasingly to prevent life-threatening bleeding in women after giving birth in community settings in low income countries, according to a review of all the available research published today (Monday) in the Journal of the Royal Society of Medicine. [1]

Misoprostol (brand name Cytotec) was originally developed for treating gastric ulcers, but is increasingly used in low- and middle-income countries for preventing postpartum haemorrhage (PPH). It is given to women during labour to prevent uncontrolled bleeding, and it is included on the World Health Organisation's Essential Medicines List for this use.

However, researchers led by Professor Allyson Pollock from the Centre for Primary Care and Public Health at Queen Mary, University of London (UK) identified 172 studies on the use of misoprostol during labour and found that only six had enough information to enable them to review whether or not the drug was effective in preventing PPH in rural and community settings in low income countries. The six studies failed to provide sufficient evidence that the drug worked and most had problems with study design and the fact the findings were not applicable generally.

"Current evidence to support the use of misoprostol in home or community settings in low- and middle-income countries for the prevention of postpartum haemorrhage is, at best, inconclusive," said Professor Pollock.

"Yet, despite there being no proper evidence of benefit, the WHO and some countries have put it on the Essential Medicine Lists and the drug is being pushed hard by networks of global public-private partnerships and industry in low- and middle-income countries. Countries such as Nepal, India and Uganda are promoting and using it. We urge the WHO to urgently review its decision to put misoprostol on its Essential Medicines List."

According to WHO estimates, there were 342,900 deaths related to pregnancy and childbirth in 2008, most of them occurring in developing countries. A quarter of these are thought to be associated with PPH while giving birth.

The main risk factor for PPH is anaemia, which is easily treated if it is diagnosed. But without antenatal screening for the condition it is impossible to identify women who may have developed it and who are at increased risk of life-threatening bleeding during labour.

"The most effective preventive strategy for PPH is prevention of anaemia, good antenatal care including good hygiene and sanitation and good care during labour," said Professor Pollock. "Developed countries would not dream of giving women misoprostol during labour on the basis of the current evidence, yet industry and health practitioners are pushing it hard in developing countries."

One of the reasons that misoprostol is popular in developing countries is that it is a fairly stable drug that doesn't degrade if not kept in cold storage conditions, and which does not have to be given intravenously. For this reason, it is more likely to be used outside hospitals, in settings such as the home and local community when women go into labour.

"Countries should be concentrating on improving their primary care facilities, rather than thinking there is a pill to prevent every ill," said Professor Pollock. "Misoprostol is being used inappropriately at present, and the money being spent on purchasing the drug would be better spent elsewhere, for instance, in ensuring there are skilled attendants during delivery and adequate antenatal services that can detect and help to prevent complications."


'/>"/>
Contact: Emma Mason
e.mason@qmul.ac.uk
Queen Mary, University of London
Source:Eurekalert

Related medicine news :

1. Researchers find evidence of banned antibiotics in poultry products
2. Report says new evidence could tip the balance in aspirin cancer prevention care
3. More Evidence Bilingualism Aids Thinking Skills
4. Novel biomarkers reveal evidence of radiation exposure
5. Antiretroviral treatment for preventing HIV infection: an evidence review for physicians
6. WSU study finds overwhelming evidence of hidden heart disease in hypertensive African-Americans
7. Study shows no evidence medical marijuana increases teen drug use
8. Study of Retired NFL Players Finds Evidence of Brain Damage
9. New evidence for link between obesity and circle of friends
10. Cochrane finds no reliable evidence on effectiveness of electric fans in heatwaves
11. Study Gives First Evidence That Adult Human Lungs Can Regrow
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:5/26/2017)... ... , ... Amir Qureshi, MD is the first physician in Arkansas to implant ... The Nuvectra™ Algovita SCS System has been FDA approved as a treatment option for ... to introduce the most powerful SCS system and the only stretchable lead on the ...
(Date:5/26/2017)... ... May 26, 2017 , ... A new analysis of community health data ... are located in the Midwest. With the average cost of healthcare rising and the ... with both the quality and affordability of where they live. An annual 2017 report ...
(Date:5/26/2017)... ... May 26, 2017 , ... via seating is proud to ... task chair specifically designed for clinical areas. Genie Copper Mesh is a crossover ... Cupron® to provide customers with a game changing chair that is affordably priced,” ...
(Date:5/26/2017)... ... ... After raising nearly $30,000 on Kickstarter , about three-times its original campaign ... crowdfunding price on Indiegogo . , “Along with creating an anti-stress gadget to ... fidget toy to the market that was made of superior quality and wouldn’t break ...
(Date:5/26/2017)... (PRWEB) , ... May 26, 2017 , ... Silver Birch ... community, which is located on more than four acres of land at 5620 Sohl ... , The 103,000 square-foot building includes 125 studio and one-bedroom apartments. Each of ...
Breaking Medicine News(10 mins):
(Date:5/6/2017)... , May 5, 2017   Provista , a proven ... than 200,000 customers, today announced Jim Cunniff as ... of executive and business experience to Provista, including most recently ... in California . He assumed his new ... is a great fit for Provista," says Jody Hatcher ...
(Date:5/4/2017)... Tenn. , May 4, 2017  A ... Infection Control, Ultraviolet-C light as a ... Tru-D SmartUVC,s ability to reduce bioburden on anesthesia ... bioburden reduction on high-touch, complex medical equipment surfaces ... surgical infections. "This study further validates ...
(Date:5/4/2017)... May 4, 2017  A new tight-tolerance microextrusion ... other highly-engineered materials, is being launched by Natvar, ... been developed in recent years to service a ... surgical applications. More expensive materials such as glass ... tubing due to their ability to consistently hold ...
Breaking Medicine Technology: