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Prevents stomach ulcers caused by nonsteroidal anti-inflammatory drugs (NSAIDs).

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Results: 21 to 40 of 110

Mifepristone-misoprostol dosing interval and effect on induction abortion times: a systematic review

OBJECTIVE: To examine the effect of the interval between mifepristone and misoprostol administration on induction time (first misoprostol dose to abortion), total procedure time (mifepristone administration to abortion), and safety and efficacy in second-trimester induction abortion (13-24 weeks).

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2013

Termination of second-trimester pregnancy by mifepristone combined with misoprostol versus intra-amniotic injection of ethacridine lactate (Rivanol): a systematic review of Chinese trials

BACKGROUND: Mifepristone combined with misoprostol for second-trimester abortion (MM) and intra-amniotic injection of ethacridine lactate (EL; Rivanol®) are the common methods for termination of second-trimester pregnancy in China. The systematic review of relevant literature was conducted to evaluate the effectiveness and safety on termination of second-trimester pregnancy using MM, introduced in 1988 in China, versus the Chinese routinely used method since 1970 -- EL. The review was conducted to evaluate mifepristone combined with the misoprostol versus intra-amniotic injection of ethacridine lactate in China for termination of second-trimester pregnancy with respect to efficacy, side effects, complications and so on.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2011

Intravaginal misoprostol versus Foley catheter for labour induction: a meta-analysis

BACKGROUND: There are a number of agents used for cervical ripening prior to the induction of labour. Two commonly used agents are intravaginal misoprostol and a transcervical Foley catheter.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2011

Misoprostol to prevent and treat postpartum haemorrhage: a systematic review and meta-analysis of maternal deaths and dose-related effects

The review found that for prevention or treatment of postpartum haemorrhage, 400?g of misoprostol appeared to be safer than 600?g and equally effective. The authors recommended more research on the effects of misoprostol. Although some review processes were not reported in detail, the review was generally well conducted and the authors? cautious conclusions appear reliable.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2009

Effect of misoprostol versus oxytocin during caesarean section: a systematic review and meta-analysis

BACKGROUND: The efficacy of misoprostol versus oxytocin for reducing blood loss during caesarean section remains unclear.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2013

Low-dose oral misoprostol for induction of labor: a systematic review

This review assessed the effects of low-dose oral misoprostol compared with dinoprostone, vaginal misoprostol and oxytocin for labour induction in women with a viable foetus and found it to be at least as effective as both vaginal misoprostol and vaginal dinoprostone. Although aspects of the review were unclear, it was of a sufficient standard and the conclusion may be reliable.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2009

Advance distribution of misoprostol for preventing and treating excessive blood loss after birth

Excessive blood loss after birth remains an important cause of severe ill health and death of mothers particularly in settings where births still occur at home. The commonly used drugs (oxytocin and ergometrine) that help to reduce blood loss by making the womb contract immediately after birth need to be given by injection, and therefore cannot be used in the absence of a trained health professional. They also need to be stored in the refrigerator to remain effective. Misoprostol, another drug that helps the womb to contract strongly after birth, has an advantage over oxytocin and ergometrine because it is almost as effective, can be given by mouth and does not have any special storage requirements. Its side effects (particularly fever and shivering) are often minor and self‐limiting and so do not require any additional medication. For these reasons, misoprostol could be used by lay health workers and the women themselves or a family member in places where births outside of a health facility are the norm. In some remote parts of the world where home birth is unavoidable, providing misoprostol well ahead of labour and childbirth to lay health workers and pregnant women themselves for self‐use has recently become an attractive approach to ensure that the drug is available to the women who need it at the point of birth. However, there are concerns that misoprostol provided in this way may cause harm to the mother and her baby if used for other purposes such as starting labour or terminating a pregnancy. This review set out to determine whether increasing access to misoprostol by providing it ahead of labour and childbirth to lay individuals makes a difference to the health of the mother and her baby. The review found that no randomised trials had been conducted on this topic. There is therefore insufficient evidence to support a system of distributing misoprostol ahead of labour and childbirth within the community for preventing or treating excessive blood loss after birth.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Misoprostol for termination of pregnancy with intrauterine fetal demise in the second and third trimester of pregnancy: a systematic review

The review concluded that among women with foetal death in the second or third trimester, vaginal misoprostol was less effective than oral misoprostol at achieving uterine evacuation within 24 hours, but not within 48 hours. In view of the limitations of the evidence base, small sample sizes and heterogeneity between studies, the authors' conclusions may not be reliable.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2009

Comparison of sublingual versus vaginal misoprostol for second-trimester pregnancy termination: a meta-analysis

The review concluded that sublingual and vaginal misoprostol were safe and effective for mid-trimester pregnancy termination. The review was generally well conducted, but potential trial quality issues, small number of trials for some outcomes and notable variation limit the reliability of the pooled results.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2011

Misoprostol for second trimester pregnancy termination in women with prior caesarean: a systematic review

The authors concluded that second trimester misoprostol termination appeared safe in women with one prior low-transverse caesarean; there was insufficient data to draw conclusions about women with multiple prior low transverse caesarean or prior classical caesarean delivery. Given the absence of high-quality studies, the reliability of the authors' conclusions is unclear and their caution justified.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2009

Comparison of sublingual versus vaginal misoprostol for the induction of labour: a systematic review

This review concluded that sublingual administration of misoprostol was comparable to vaginal administration for inducing labour in full-term pregnancies, but it appeared to offer no additional clinical advantages. The authors' conclusions reflected the evidence shown, but the possibility of bias and errors during the review process means that caution is required when interpreting these findings.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2008

Misoprostol for induction of labour to terminate pregnancy in the second or third trimester for women with a fetal anomaly or following intrauterine fetal death

A woman may need to give birth prior to the spontaneous onset of labour in middle to late pregnancy to terminate the pregnancy in situations where the fetus, if born alive, would not survive or would have permanent handicaps, or where the fetus has died in utero (also called a stillbirth). Misoprostol is a prostaglandin medication that can be used to induce labour in these situations. This review included 38 randomised controlled studies, involving 3679 women. Vaginal misoprostol was as effective as other agents in inducing labour and achieving vaginal birth within 24 hours, with a reduction in the occurrence of maternal side effects. Side effects include gastrointestinal disturbance (nausea, vomiting, diarrhoea). The information on rare adverse events (including uterine rupture) is limited.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2010

Misoprostol compared with prostaglandin E2 for labour induction in women at term with intact membranes and unfavourable cervix: a systematic review

The authors concluded that in women at term with intact membranes and unfavourable cervix, misoprostol did not reduce the Caesarean section rate, and increased the risk of tachysystole and hyperstimulation, compared with prostaglandin E2. Overall, the review was well conducted and the authors' conclusions appear appropriate. However, the absence of evidence of consistent results across studies weakens the robustness of the conclusions.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2006

Buccal or sublingual misoprostol for cervical ripening and induction of labour

Not enough evidence to say if misoprostol administered under the tongue or in the cheek is safe for induction of labour.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Vaginal misoprostol is effective in inducing labour but more research is needed on safety

Sometimes it is necessary to bring on labour artificially because of safety concerns for the mother or baby. Misoprostol is a hormone given by insertion through the vagina or rectum, or by mouth to ripen the cervix and bring on labour. The review of 121 trials found that larger doses of misoprostol are more effective than prostaglandin and that oxytocin is used in addition less often. However, misoprostol also increases hyperstimulation of the uterus. With smaller doses, the results are similar to other methods. The trials reviewed are too small to determine whether the risk of rupture of the uterus is increased. More research is needed into the safety and best dosages of misoprostol. Another Cochrane review has shown that the oral route of administration is preferable to the vaginal route.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Postpartum misoprostol for preventing maternal mortality and morbidity

Bleeding from the uterus or womb after childbirth is normal, but excessive bleeding (haemorrhage) is an important cause of death and can be reduced by medication that causes the uterus to contract. Misoprostol is one such medication and is a tablet marketed to treat certain stomach ulcers but which also contracts the uterus and reduces bleeding. It may also have harmful side effects, in particular raised body temperature (pyrexia) and shivering. Misoprostol can more easily be distributed at community level than less stable, injectable medication such as oxytocin to prevent or treat severe bleeding in woman after giving birth (postpartum haemorrhage). This review investigated whether giving misoprostol to women after birth to prevent or treat excessive bleeding reduces maternal deaths and severe complications other than blood loss (which is covered in separate reviews). We included 78 randomised controlled studies involving 59,216 women. The variety of study designs, populations studied, routes of administration and co‐interventions, as well as the exceptionally high incidence of hyperpyrexia in Ecuador were limiting factors. Maternal deaths, and the combined outcome, death or severe illness resulting in major surgery, admission to intensive care or vital organ failure (excluding very high fever) were not reduced by misoprostol. The known side effects of misoprostol (fever and very high fever) were worse with dosages of 600 µg or more than with lower dosages. Therefore, the review supports the use of the lowest effective misoprostol dose to prevent or treat maternal bleeding after the birth of the baby, and calls for more research to find out the optimal dosage, with continued surveillance for serious side effects.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Oral misoprostol for induction of labour

Oral misoprostol is effective at inducing (starting) labour. It is more effective than placebo, as effective as vaginal misoprostol and results in fewer caesarean sections than vaginal dinoprostone or oxytocin. However, there are still not enough data from randomised controlled trials to determine the best dose to ensure safety.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Adjusted doses of oral misoprostol for treating slow progress in labour

Abnormally slow progress in labour (labour dystocia) may lead to serious complications including death for women and their babies. Drugs to increase the frequency and strength of contractions have often been used in such births. Misoprostol is an inexpensive and stable drug that stimulates uterine contractions, but it can have serious and even life‐threatening side‐effects and so the dose has to be carefully adjusted. Titration refers to the process of adjusting the dosing of a medication on the basis of frequent monitoring to achieve the best outcomes. Titrated misoprostol could be effective in treating delayed progress in labour and as an alternative to oxytocin which is harder to store and is given intravenously by infusion.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Management of early pregnancy loss

OBJECTIVES: In order to assess the available evidence on the management of early pregnancy loss, we performed a meta-analysis on the subject.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2004

Comparative effectiveness, safety and acceptability of medical abortion at home and in a clinic: a systematic review

OBJECTIVE: To compare medical abortion practised at home and in clinics in terms of effectiveness, safety and acceptability.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2011

Systematic Reviews in PubMed

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