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. 2014 Feb 12;2014(2):CD003249. doi: 10.1002/14651858.CD003249.pub3

Comparison 2. Sublingual misoprostol versus intravenous oxytocin therapy for primary PPH treatment among women who have not received any conventional uterotonic therapy.

Outcome or subgroup title No. of studies No. of participants Statistical method Effect size
1 Maternal mortality 2 1787 Risk Ratio (M‐H, Fixed, 95% CI) 0.99 [0.06, 15.74]
1.1 800 mcg misoprostol versus 40 IU oxytocin 2 1787 Risk Ratio (M‐H, Fixed, 95% CI) 0.99 [0.06, 15.74]
2 Serious maternal morbidity 2 1787 Risk Ratio (M‐H, Fixed, 95% CI) 0.33 [0.01, 8.06]
2.1 800 mcg misoprostol versus 40 IU oxytocin 2 1787 Risk Ratio (M‐H, Fixed, 95% CI) 0.33 [0.01, 8.06]
3 Admission to intensive care 2 1787 Risk Ratio (M‐H, Fixed, 95% CI) 0.33 [0.01, 8.06]
3.1 800 mcg misoprostol versus 40 IU oxytocin 2 1787 Risk Ratio (M‐H, Fixed, 95% CI) 0.33 [0.01, 8.06]
4 Hysterectomy 2 1787 Risk Ratio (M‐H, Fixed, 95% CI) 1.98 [0.36, 10.72]
4.1 800 mcg misoprostol versus 40 IU oxytocin 2 1787 Risk Ratio (M‐H, Fixed, 95% CI) 1.98 [0.36, 10.72]
5 Blood loss 500 mL or more after enrolment 2 1787 Risk Ratio (M‐H, Random, 95% CI) 1.66 [0.69, 4.04]
5.1 800 mcg misoprostol versus 40 IU oxytocin 2 1787 Risk Ratio (M‐H, Random, 95% CI) 1.66 [0.69, 4.04]
6 Mean blood loss after enrolment 2 1787 Mean Difference (IV, Fixed, 95% CI) 44.86 [26.50, 63.22]
6.1 800 mcg misoprostol versus 40 IU oxytocin 2 1787 Mean Difference (IV, Fixed, 95% CI) 44.86 [26.50, 63.22]
7 Blood loss 1000 mL or more after enrolment 2 1787 Risk Ratio (M‐H, Fixed, 95% CI) 2.65 [1.04, 6.75]
7.1 800 mcg misoprostol versus 40 IU oxytocin 2 1787 Risk Ratio (M‐H, Fixed, 95% CI) 2.65 [1.04, 6.75]
8 Blood transfusion within 24 hours 2 1787 Risk Ratio (M‐H, Fixed, 95% CI) 1.47 [1.02, 2.14]
8.1 800 mcg misoprostol versus 40 IU oxytocin 2 1787 Risk Ratio (M‐H, Fixed, 95% CI) 1.47 [1.02, 2.14]
9 Duration from randomisation till cessation of bleeding or satisfactory response 2 1787 Mean Difference (IV, Fixed, 95% CI) 0.06 [‐1.02, 1.14]
9.1 800 mcg misoprostol versus 40 IU oxytocin 2 1787 Mean Difference (IV, Fixed, 95% CI) 0.06 [‐1.02, 1.14]
10 Additional uterotonics after enrolment 2 1787 Risk Ratio (M‐H, Random, 95% CI) 1.30 [0.57, 2.94]
10.1 800 mcg misoprostol versus 40 IU oxytocin 2 1787 Risk Ratio (M‐H, Random, 95% CI) 1.30 [0.57, 2.94]
11 Examination under anaesthesia 2 1787 Risk Ratio (M‐H, Random, 95% CI) 1.27 [0.87, 1.87]
11.1 800 mcg misoprostol versus 40 IU oxytocin 2 1787 Risk Ratio (M‐H, Random, 95% CI) 1.27 [0.87, 1.87]
12 Uterine tamponade after enrolment 2 1483 Risk Ratio (M‐H, Fixed, 95% CI) 0.32 [0.07, 1.40]
12.1 600 mcg 2 1483 Risk Ratio (M‐H, Fixed, 95% CI) 0.32 [0.07, 1.40]
12.2 800 mcg 0 0 Risk Ratio (M‐H, Fixed, 95% CI) 0.0 [0.0, 0.0]
13 Bimanual compression 2 1787 Risk Ratio (M‐H, Fixed, 95% CI) 1.06 [0.96, 1.18]
13.1 800 mcg misoprostol versus 40 IU oxytocin 2 1787 Risk Ratio (M‐H, Fixed, 95% CI) 1.06 [0.96, 1.18]
14 Artery ligation (uterine and/or hypogastric arteries) after enrolment 2 1787 Risk Ratio (M‐H, Fixed, 95% CI) 0.0 [0.0, 0.0]
14.1 800 mcg misoprostol versus 40 IU oxytocin 2 1787 Risk Ratio (M‐H, Fixed, 95% CI) 0.0 [0.0, 0.0]
15 Arterial embolisation after enrolment 2 1787 Risk Ratio (M‐H, Fixed, 95% CI) 0.0 [0.0, 0.0]
15.1 800 mcg misoprostol versus 40 IU oxytocin 2 1787 Risk Ratio (M‐H, Fixed, 95% CI) 0.0 [0.0, 0.0]
16 Uterine tamponade after enrolment 2 1787 Risk Ratio (M‐H, Fixed, 95% CI) 0.0 [0.0, 0.0]
16.1 800 mcg misoprostol versus 40 IU oxytocin 2 1787 Risk Ratio (M‐H, Fixed, 95% CI) 0.0 [0.0, 0.0]
17 Unsatisfactory response after enrolment after enrolment 2 1787 Risk Difference (M‐H, Random, 95% CI) 0.03 [‐0.02, 0.08]
17.1 800 mcg misoprostol versus 40 IU oxytocin 2 1787 Risk Difference (M‐H, Random, 95% CI) 0.03 [‐0.02, 0.08]
18 Uterine compression stitch after enrolment 2 1787 Risk Ratio (M‐H, Fixed, 95% CI) 0.0 [0.0, 0.0]
18.1 800 mcg misoprostol versus 40 IU oxytocin 2 1787 Risk Ratio (M‐H, Fixed, 95% CI) 0.0 [0.0, 0.0]
19 Any surgical co‐interventions (uterine tamponade, artery ligations, arterial embolisation) excluding hysterectomy after enrolment 2 1787 Risk Ratio (M‐H, Fixed, 95% CI) 0.33 [0.01, 8.06]
19.1 800 mcg misoprostol versus 40 IU oxytocin 2 1787 Risk Ratio (M‐H, Fixed, 95% CI) 0.33 [0.01, 8.06]
20 Nausea 2 1787 Risk Ratio (M‐H, Fixed, 95% CI) 0.98 [0.76, 1.25]
20.1 800 mcg misoprostol versus 40 IU oxytocin 2 1787 Risk Ratio (M‐H, Fixed, 95% CI) 0.98 [0.76, 1.25]
21 Vomiting 2 1787 Risk Ratio (M‐H, Fixed, 95% CI) 2.52 [1.45, 4.38]
21.1 800 mcg misoprostol versus 40 IU oxytocin 2 1787 Risk Ratio (M‐H, Fixed, 95% CI) 2.52 [1.45, 4.38]
22 Diarrhoea 2 1787 Risk Ratio (M‐H, Fixed, 95% CI) 1.39 [0.44, 4.36]
22.1 800 mcg misoprostol versus 40 IU oxytocin 2 1787 Risk Ratio (M‐H, Fixed, 95% CI) 1.39 [0.44, 4.36]
23 Headache 2 1787 Risk Ratio (M‐H, Fixed, 95% CI) 1.00 [0.23, 4.38]
23.1 800 mcg misoprostol versus 40 IU oxytocin 2 1787 Risk Ratio (M‐H, Fixed, 95% CI) 1.00 [0.23, 4.38]
24 Shivering 2 1787 Risk Ratio (M‐H, Fixed, 95% CI) 2.70 [2.28, 3.19]
24.1 800 mcg misoprostol versus 40 IU oxytocin 2 1787 Risk Ratio (M‐H, Fixed, 95% CI) 2.70 [2.28, 3.19]
25 Feeling faint or fainting 2 1787 Risk Ratio (M‐H, Fixed, 95% CI) 1.00 [0.73, 1.39]
25.1 800 mcg misoprostol versus 40 IU oxytocin 2 1787 Risk Ratio (M‐H, Fixed, 95% CI) 1.00 [0.73, 1.39]
26 Maternal pyrexia 38 degrees or more 2 1787 Risk Difference (M‐H, Random, 95% CI) 0.23 [‐0.08, 0.54]
26.1 800 mcg misoprostol versus 40 IU oxytocin 2 1787 Risk Difference (M‐H, Random, 95% CI) 0.23 [‐0.08, 0.54]
27 Maternal pyrexia 40 degrees or more 2 1787 Risk Ratio (M‐H, Random, 95% CI) 23.54 [0.50, 1104.42]
27.1 800 mcg misoprostol versus 40 IU oxytocin 2 1787 Risk Ratio (M‐H, Random, 95% CI) 23.54 [0.50, 1104.42]
28 Allergy 2 1787 Risk Ratio (M‐H, Fixed, 95% CI) 1.00 [0.14, 7.09]
28.1 800 mcg misoprostol versus 40 IU oxytocin 2 1787 Risk Ratio (M‐H, Fixed, 95% CI) 1.00 [0.14, 7.09]