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Misoprostol in the Treatment of Postpartum Hemorrhage

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ClinicalTrials.gov Identifier: NCT00116480
Recruitment Status : Completed
First Posted : June 30, 2005
Last Update Posted : March 19, 2009
Information provided by:

Study Description
Brief Summary:
Postpartum haemorrhage (PPH) remains a leading cause of maternal mortality, despite treatment with conventional methods. Uncontrolled reports and three small randomised controlled trials have suggested that misoprostol may have an additive effect to routine treatment, and there is a serious danger that this method will be used widely without research to document the effectiveness or risks of this method. In this randomised controlled trial (RCT), we propose to test whether 600 μg of sublingually administered misoprostol in women requiring additional uterotonics after delivery, and after routine syntocinon to all women during or after delivery, has additional effects above the additional conventional uterotonics in reducing PPH. Women with measured blood loss greater than or equal to 500 mls in 4 Karachi hospitals who give consent will be given locally routine treatment for PPH. In addition, they will be enrolled by drawing the next of a series of randomised treatment packs containing misoprostol or placebo. The primary outcome measure will be blood loss greater than or equal to 500 mls after enrolment.

Condition or disease Intervention/treatment
Postpartum Hemorrhage Drug: Misoprostol

Study Design

Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 61 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Triple (Participant, Care Provider, Investigator)
Primary Purpose: Treatment
Official Title: Misoprostol in the Treatment of Post Partum Hemorrhage: A Placebo Randomised Controlled Trial in 4 Karachi Hospitals
Study Start Date : December 2005
Primary Completion Date : April 2007
Study Completion Date : April 2007

Resource links provided by the National Library of Medicine

Drug Information available for: Misoprostol
U.S. FDA Resources

Arms and Interventions

Arm Intervention/treatment
Experimental: Misoprostol
three tablets of active misoprostol (600 mcg) given sublingually
Drug: Misoprostol
600 mcg of sublingual misoprostol
Placebo Comparator: Placebo
three tablets resembling misoprostol given sublingually
Drug: Misoprostol
600 mcg of sublingual misoprostol

Outcome Measures

Primary Outcome Measures :
  1. Blood loss greater than or equal to 500 mls after enrolment [ Time Frame: Blood loss measured for minimum of 1 hour or until active bleeding ceased ]

Secondary Outcome Measures :
  1. Average blood loss [ Time Frame: Blood loss measured for minimum of one hour or until active bleeding ceased ]
  2. Clinical complications (need for transfusion, hysterectomy) [ Time Frame: After delivery and prior to hospital discharge ]
  3. Pre-delivery and post-delivery hemoglobin measures [ Time Frame: Pre-delivery hemoglobin measured upon admission to hospital (during labor) and measured postpartum 12-24 hours after delivery ]
  4. Side effects [ Time Frame: observed or reported following study treatment and prior to discharge ]

Eligibility Criteria

Information from the National Library of Medicine

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Ages Eligible for Study:   Child, Adult, Senior
Sexes Eligible for Study:   Female
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • All women delivering vaginally with clinically diagnosed PPH requiring uterotonics

Exclusion Criteria:

  • Refusal to give consent for participation or if the woman is too distressed to give consent
  • Woman is not entitled to give informed consent (e.g. minors without a guardian)
  • Woman who had a caesarean section
  • Delivery is regarded as abortion (gestational age < 28 weeks)
Contacts and Locations

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT00116480

Aga Khan University Hospital
Karachi, Pakistan
The Aga Khan Health Services
Karachi, Pakistan
Sponsors and Collaborators
Gynuity Health Projects
Aga Khan University
Aga Khan Health Services
The Aga Khan Foundation
Family Care International
Principal Investigator: Nadeem F Zuberi, MD Aga Khan University Hospital, Karachi
More Information

Additional Information:
Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
Responsible Party: Gynuity Health Projects
ClinicalTrials.gov Identifier: NCT00116480     History of Changes
Other Study ID Numbers: 2.4.2
First Posted: June 30, 2005    Key Record Dates
Last Update Posted: March 19, 2009
Last Verified: March 2009

Keywords provided by Gynuity Health Projects:
Postpartum Haemorrhage

Additional relevant MeSH terms:
Postpartum Hemorrhage
Pathologic Processes
Obstetric Labor Complications
Pregnancy Complications
Puerperal Disorders
Uterine Hemorrhage
Abortifacient Agents, Nonsteroidal
Abortifacient Agents
Reproductive Control Agents
Physiological Effects of Drugs
Anti-Ulcer Agents
Gastrointestinal Agents