{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T19:56:06Z","timestamp":1770753366395,"version":"3.50.0"},"reference-count":37,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2012,6,17]],"date-time":"2012-06-17T00:00:00Z","timestamp":1339891200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2012,7]]},"abstract":"<jats:p><jats:italic>Please cite this paper as:<\/jats:italic> Bellad M, Tara D, Ganachari M, Mallapur M, Goudar S, Kodkany B, Sloan N, Derman R. Prevention of postpartum haemorrhage with sublingual misoprostol or oxytocin: a double\u2010blind randomised controlled trial. BJOG 2012;119:975\u2013986.<\/jats:p><jats:p><jats:bold>Objective\u2002<\/jats:bold> Sublingual misoprostol produces a rapid peak concentration, and is more effective than oral administration. We compared the postpartum measured blood loss with 400\u2003\u03bcg powdered sublingual misoprostol and after standard care using 10\u2003iu intramuscular (IM) oxytocin.<\/jats:p><jats:p><jats:bold>Design\u2002<\/jats:bold> Double\u2010blind randomised controlled trial.<\/jats:p><jats:p><jats:bold>Setting\u2002<\/jats:bold> A teaching hospital: J N Medical College, Belgaum, India.<\/jats:p><jats:p><jats:bold>Sample\u2002<\/jats:bold> A cohort of 652 consenting eligible pregnant women admitted to the labour room.<\/jats:p><jats:p><jats:bold>Methods\u2002<\/jats:bold> Subjects were assigned to receive the study medications and placebos within 1\u2003minute of clamping and cutting the cord by computer\u2010generated randomisation. Chi\u2010square and bootstrapped Student\u2019s <jats:italic>t<\/jats:italic>\u2010tests were used to test categorical and continuous outcomes, respectively.<\/jats:p><jats:p><jats:bold>Main outcome measures\u2002<\/jats:bold> Measured mean postpartum blood loss and haemorrhage (PPH, loss \u2265500\u2003ml), &gt;10% pre\u2010 to post\u2010partum decline in haemoglobin, and reported side effects.<\/jats:p><jats:p><jats:bold>Results\u2002<\/jats:bold> The mean blood loss with sublingual misoprostol was 192\u2003\u00b1\u2003124\u2003ml (<jats:italic>n<\/jats:italic>\u2003=\u2003321) and 366\u2003\u00b1\u2003136\u2003ml with oxytocin IM (<jats:italic>n<\/jats:italic>\u2003=\u2003331, <jats:italic>P\u2003<\/jats:italic>\u2264\u20030.001). The incidence of PPH was 3.1% with misoprostol and 9.1% with oxytocin (<jats:italic>P\u2003<\/jats:italic>=\u20030.002). No woman lost \u22651000\u2003ml of blood. We observed that 9.7% and 45.6% of women experienced a haemoglobin decline of &gt;10% after receiving misoprostol and oxytocin, respectively (<jats:italic>P\u2003<\/jats:italic>\u2264\u20030.001). Side effects were significantly greater in the misoprostol group than in the oxytocin group.<\/jats:p><jats:p><jats:bold>Conclusion\u2002<\/jats:bold> Unlike other studies, this trial found sublingual misoprostol more effective than intramuscular oxytocin in reducing PPH, with only transient side effects being greater in the misoprostol group. The sublingual mode and\/or powdered formulation may increase the effectiveness of misoprostol, and render it superior to injectable oxytocin for the prevention of PPH. Further research is needed to confirm these results.<\/jats:p>","DOI":"10.1111\/j.1471-0528.2012.03341.x","type":"journal-article","created":{"date-parts":[[2012,6,18]],"date-time":"2012-06-18T02:51:29Z","timestamp":1339987889000},"page":"975-986","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["Prevention of postpartum haemorrhage with sublingual misoprostol or oxytocin: a double\u2010blind randomised controlled 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