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CompletedNCT01373359Updated Jun 14, 2011

Prevention of Postpartum Haemorrhage With Sublingual Misoprostol or Oxytocin

A Phase 3 interventional study of Misoprostol and Oxytocin in Postpartum Hemorrhage, sponsored by Jawaharlal Nehru Medical College. Completed at 1 site in India. Open to female participants aged 18 Years to 35 Years. Per ClinicalTrials.gov, last updated 2011-06-14.

Sponsored by Jawaharlal Nehru Medical College · Phase 3, Interventional, and Prevention

Phase
Phase 3
Study type
Interventional
Enrollment
652
Allocation
Randomized
Ages
18 Years to 35 Years
Sex
Female
01

Study summary

Sublingual misoprostol produces rapid peak concentration and is more effective than oral misoprostol for prevention of excessive postpartum bleeding. The study hypothesis was to test whether women receiving sublingual misoprostol for prevention of postpartum hemorrhage have 30 ml less average blood loss than women receiving oxytocin, the standard of care for prevention of postpartum hemorrhage. We conducted a Double blind randomized controlled trial of .652 consenting, eligible pregnant women admitted to the labor room of the teaching hospital at J N Medical College, Belgaum, India. Women participating in the study were assigned by computer generated randomization to receive the study medications and placebos within one minute after clamping and cutting the umbilical cord. We also looked at the drugs effects on postpartum blood loss at or above ≥500 ml (considered hemorrhage), and the percent of women experiencing more than a 10% decline in haemoglobin, and reported drug side effects.

02

Conditions studied

  • Postpartum Hemorrhage

Keywords

  • Misoprostol, oxytocin, postpartum blood loss, hemoglobin
03

Who can participate

Ages eligible
18 Years to 35 Years
Sexes eligible
Female
Accepts healthy volunteers
No

Inclusion criteria

  • Women with a gestational age >28weeks
  • singleton pregnancy with cephalic presentation anticipating a normal spontaneous vaginal delivery (including episiotomy)
  • a haemoglobin ≥ 8g/dl upon presentation who were admitted to labour room in the KLE teaching hospital attached to J N Medical College, Belgaum

Exclusion criteria

Exclusion Criteria:

  • Women with pregnancy induced hypertension
  • antepartum haemorrhage
  • previous caesarean section or presence of uterine scar
  • diagnosed chorioamnionitis
  • oxytocin induction or augmentation of labour
  • intrauterine death
  • diagnosed medical disorders (such as diabetes, cardiac, renal and hepatic diseases, etc.) or those in active labour (defined as >4 cm dilatation)
04

Study design

Phase
Phase 3
Primary purpose
Prevention
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Double (Participant, Care provider)
Enrollment
652 participants (actual)

Study arms

  • Experimental
    Sublingual misoprostol

    400 µg powdered misoprostol administered sublingually; IM placebo

    Drug: Misoprostol

  • Active comparator
    Oxytocin

    10 IU IM oxytocin; placebo powder

    Drug: Oxytocin

Interventions

  • DrugMisoprostol

    400 µg sublingual misoprostol

  • DrugOxytocin

    10 IU IM

05

What researchers measure

Primary outcomes

  1. mean blood loss

    Blood loss was objectively measured using the BRASSS-V DrapeTM, placed under the buttock before the delivery. The calibrated blood collection receptacle was opened after the delivery and drainage of amniotic fluid. Blood collected in the drape was transferred to measuring jar with 10 ml calibrations for accuracy. Blood soaked swabs were weighed in grams, and the known dry weight of the swabs was subtracted; this volume was added to the drape's measured blood volume (assuming 1 gm equivalence with 1 ml).

    Time frame: 2 hours after delivery

  2. postpartum hemorrhage (Blood loss >500 mls)

    Blood loss was objectively measured using the BRASSS-V DrapeTM, placed under the buttock before the delivery. The calibrated blood collection receptacle was opened after the delivery and drainage of amniotic fluid. Blood collected in the drape was transferred to measuring jar with 10 ml calibrations for accuracy. Blood soaked swabs were weighed in grams, and the known dry weight of the swabs was subtracted; this volume was added to the drape's measured blood volume (assuming 1 gm equivalence with 1 ml).

    Time frame: 2 hours after delivery

Secondary outcomes

  1. The percent of women experiencing a ≥10% postpartum decline in haemoglobin

    Hemoglobin was obtained at presentation for delivery and again between 12 and 48 hours after delivery.

    Time frame: At presentation for delivery and 12-48 hours after delivery

  2. Medication side effects

    Self reported side effects including nausea, vomiting, diarrhoea, abdominal pain, shivering and elevated temperature

    Time frame: 2 hours after delivery

06

Study locations

1 site
  • Jawaharlal Nehru Medical College
    Belgaum, Karnataka 590010, India
07

Registry details

Key details

Study ID
NCT01373359
Lead sponsor
Jawaharlal Nehru Medical College
Collaborators
Cipla Ltd., AstraZeneca
First posted
Jun 14, 2011
Start date
Mar 2007
Primary completion
Jan 2008
Completion
Jan 2008
Last update
Jun 14, 2011

Study contacts

M B Bellad, M.D.
principal investigator · Jawaharlal Nehru Medical College

Oversight

Data monitoring committee
No
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