-VISIT OUR OTHER FORUMS- OB-GYN-L Ultrasound Ultrasound History Fibroid Forum Physicians-in-Training Tech Talk OBSTET-L (portuguese) OBGIN-L (spanish) Nursing

Re: Cytotec and postpartum hemorrhage From: art fougner, md (evsono@pipeline.com) Sat Jul 19 11:35:20 2003 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: art fougner, md: "Re: Cytotec and postpartum hemorrhage" Previous message: Steve & Eryl Raymond: "Re: ABOG Case list software" In reply to: Steve & Eryl Raymond: "Re: Cytotec and postpartum hemorrhage" Next in thread: Luis Sanchez-Ramos, MD: "Re: Cytotec and postpartum hemorrhage" Reply: Luis Sanchez-Ramos, MD: "Re: Cytotec and postpartum hemorrhage" Steve - is this what you're looking for? Am J Obstet Gynecol. 2002 Oct;187(4):1038-45. Related Articles, Links Is rectal misoprostol really effective in the treatment of third stage of labor? A randomized controlled trial. Caliskan E, Meydanli MM, Dilbaz B, Aykan B, Sonmezer M, Haberal A. Social Security Council: Maternity and Women's Health Teaching Hospital, Ballibaba sok. No: 86/3, 06660 Kucukesat, Ankara, Turkey. eray68@hotmail.com OBJECTIVE: The purpose of this study was to compare misoprostol 600 microg intrarectally with conventional oxytocics in the treatment of third stage of labor. STUDY DESIGN: In a controlled trial, 1606 women were randomly grouped to receive (1) oxytocin 10 IU plus rectal misoprostol, (2) rectal misoprostol, (3) oxytocin 10 IU, and (4) oxytocin 10 IU plus methylergometrine. The main outcome measures were the incidence of postpartum hemorrhage and a drop in hemoglobin concentration from before delivery to 24 hours after delivery. RESULTS: The incidence of postpartum hemorrhage was 9.8% in the group that received only rectal misoprostol therapy compared with 3.5% in the group that received oxytocin and methylergometrine therapy (P =.001). There were no significant differences among the 4 groups with regard to a drop in hemoglobin concentrations. Significantly more women needed additional oxytocin in the group that received only rectal misoprostol therapy, when compared with the group that received oxytocin and methylergometrine therapy (8.3% vs 2.2%; P <.001). The primary outcome measures were similar in the group that received only rectal misoprostol therapy and the group that received only oxytocin therapy. CONCLUSION: Rectal misoprostol is significantly less effective than oxytocin plus methylergometrine for the prevention of postpartum hemorrhage. art At Fri, 18 Jul 2003, Steve & Eryl Raymond wrote: > >It seems a good time to say that we have used 5 tablets (1 gram) >rectally in cases of post partum uterine atony with patchy results. I >don't want to say that it is no use at all, but there have been >occasions where I saw no improvement, and the results could be best >described as disappointing. A study done recently, the source of which >I have totally forgotten, showed results which were worse than all other >ecbolics in current use, but better than nothing or placebo!! >Steve > >Braun, R. Daniel wrote: > >>If the uterus is still floppy and bleeding after giving pit IV, then we >>put 600 mcg intrarectlly. Someone has to reach under the drapes to do >>it. >> >>Dan >> >>-----Original Message----- >>From: Glen Elrod MD [mailto:glen.elrod@elmendorf.af.mil] >>Sent: Thursday, July 17, 2003 4:32 PM >>To: Multiple recipients of list OB-GYN-L >>Subject: Re: Cytotec and postpartum hemorrhage >> >>I've never heard it being contraindicated in asthmatics either. >> >>Dr Braun...how do you use it after c/s? Regularly or just for >>hemorrhage after pit fails? >> >>Glen >> >>At Thu, 17 Jul 2003, Efrain Ramirez wrote: >> >>>Haven't heard it is contraindicated in asthmatics - ! >>> >>>If there is no Hamabate - you can use it - rectally or/and PO - I dont >>>think it is as good as Methergine or Hemabate. >>> >>>At Thu, 17 Jul 2003, Braun, R. Daniel wrote: >>> >>>>Cytotec is also a prostaglandin. Can't use in asthmatics either. >>>> >>>>We use it after C/S. It is our second choice after pitocin. >>>> >>>>-----Original Message----- >>>>From: Glen Elrod MD [mailto:glen.elrod@elmendorf.af.mil] >>>>Sent: Thursday, July 17, 2003 10:41 AM >>>>To: Multiple recipients of list OB-GYN-L >>>>Subject: Cytotec and postpartum hemorrhage >>>> >>>>Does anyone have any experience with Cytotec and postpartum hemorrhage >>>>in women that have just undergone a c-section. I know that Cytotec is >>>>contraindicated in women with a previous c-section for labor induction. >>>> >>>>I have used cytotec rectally for women with vaginal deliveries that have >>>> >>>>postpartum hemorrhage. >>>> >>>>The reason this came up is we have a postpartum c/s that is diabetic, >>>>asthmatic, preeclamptic with a postpartum hemorrhage. Methergine is >>>>out. Hemabate is out. Pitocin was running. Pt is now several hours >>>>out from surgery. Any other suggestion? >>>> >>>>Glen >>>> >>>>-- >>>>D. Glen Elrod, Maj, USAF, MC >>>> >-- >S.H. Raymond FRCOG >Principal Specialist >Department of Obstetrics & Gynaecology >Empangeni Hospital >Private Bag X20005 >Empangeni >SOUTH AFRICA 3880 > >Phone: (+27)-35-9028560 >Fax: (+27)-35-7922596 > -- art fougner, md ich bin ein New Yorker Next message: art fougner, md: "Re: Cytotec and postpartum hemorrhage" Previous message: Steve & Eryl Raymond: "Re: ABOG Case list software" In reply to: Steve & Eryl Raymond: "Re: Cytotec and postpartum hemorrhage" Next in thread: Luis Sanchez-Ramos, MD: "Re: Cytotec and postpartum hemorrhage" Reply: Luis Sanchez-Ramos, MD: "Re: Cytotec and postpartum hemorrhage"

Return to

Mail a New Message to the Forum: ob-gyn-l@obgyn.net Forum Administrator: geffrey.klein@obgyn.net Report Technical Problems: webmaster@obgyn.net Last Updated: Wed Dec 2 04:55:51 2009

The American Medical Association is no longer designating CME hours for AMA Category II CME credit. However, physicians themselves may self designate learning activities as Category II CME credit hours if they feel it is of sufficient educational merit and meets the formal definitions of continuing medical education. OBGYN.net believes these interaction in this forum meets these criteria. For further information see the AMA web site.