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Combating Maternal Mortality in Uganda: An Assessment of the Role of Misoprostol in Prevention of Post-Partum Hemorrhage

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT01866241
Recruitment Status : Completed
First Posted : May 31, 2013
Last Update Posted : September 8, 2014
Makerere University
University Ghent
Information provided by (Responsible Party):
Mbarara University of Science and Technology

Brief Summary:
Null hypothesis: 10 IU Oxytocin is better than sublingual misoprostol 600µg in management of third stage of labor Alternative hypothesis: Sublingual misoprostol 600µg is non- inferior to 10 IU oxytocin and will not be more than 6% worse [than 10 IU oxytocin] in management of third stage of labor

Condition or disease Intervention/treatment Phase
Post Partum Hemorrhage Drug: Misoprostol Phase 3

Detailed Description:
Background: In Sub- Saharan Africa, one in 35 women die in child birth, 1000 times higher than the western world and Post-Partum Hemorrhage (PPH) accounts for the biggest percentage of maternal morbidity and mortality (WHO, 2005; WHO, 2010). Maternal Mortality in Uganda is one of the highest in the world at 435 for every 100,000 and 25% of these are due to PPH happening within 24 hours after delivery. Oxytocin, the standard of care in PPH management has registered challenges like requirement of sterile injections, requirement of trained personnel, special supply chain/storage conditions like refrigeration and protection from light affecting maximum treatment outcomes especially in poorly resourced developing countries where these are not realized. It has been argued that any effort or developments based on physiological processes towards the reduction of this horrific PPH rate would greatly have a significant impact on the lives of families and women worldwide. Several scholars have thus stressed a vital need to develop simple, practical and inexpensive techniques relevant to prevent and treat PPH in developing countries.

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 1140 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: Combating Maternal Mortality in Uganda: An Assessment of the Role of Misoprostol in Prevention of Post-Partum Hemorrhage
Study Start Date : November 2012
Actual Primary Completion Date : September 2013
Actual Study Completion Date : October 2013

Resource links provided by the National Library of Medicine

Drug Information available for: Misoprostol

Arm Intervention/treatment
Experimental: Arm A: sublingual misoprostol 600µg
Misoprostol is a uteretonic drug
Drug: Misoprostol
Is a prostaglandin
Other Name: Prostaglandin, Cytotec

Placebo Comparator: Arm B: 10 IU Oxytocin
Oytocin is a standard of care treatment for PPH

Primary Outcome Measures :
  1. Estimated Blood loss [ Time Frame: 24 hours ]
    Estimated blood loss of more than or equal to 500ml

Secondary Outcome Measures :
  1. Blood loss of more than 1000ml [ Time Frame: 24 hours ]
    Other secondary outcomes are: Hematocrit drop, additional uteretonic use

  2. 1) maternal death, 2) pre and post delivery hemoglobin changes 3) pre and post delivery hematocrit changes 4) >10% hemoglobin drop 5) mean postpartum hemoglobin and hematocrit, 6) mean measured blood loss [ Time Frame: 24 hours ]
  3. 7) placental retention 8) requirement for blood transfusion 9) requirement for additional therapeutic procedures or uterotonics 10) duration of the third stage of labor [ Time Frame: 24 hours ]

Other Outcome Measures:
  1. Uteretonic use [ Time Frame: 24 hours ]

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years to 38 Years   (Adult)
Sexes Eligible for Study:   Female
Accepts Healthy Volunteers:   No

Inclusion Criteria:Term mothers [38-41 WOA] above 18 years of age admitted at Mbarara Hospital, Uganda in active labor; anticipating vaginal delivery -

Exclusion Criteria:

Complicated labor:

  1. confirmed intra-uterine fetal death
  2. self-reported maternal heart disease
  3. current diagnosis of severe malaria or acute bacterial infection,
  4. multiple pregnancy,
  5. induced or augmented labor,
  6. elective Caesarean section,
  7. ante-partum hemorrhage,
  8. reported hypersensitivity to prostaglandins
  9. altered cognitive status (ACS) as assessed by the MRAs. -

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 identifier (NCT number): NCT01866241

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Mbarara Regional Referral Hospital
Mbarara, Uganda, 1410
Sponsors and Collaborators
Mbarara University of Science and Technology
Makerere University
University Ghent
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Study Chair: Amon Agaba, PhD Mbarara University of Science and Technology
Publications automatically indexed to this study by Identifier (NCT Number):
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Responsible Party: Mbarara University of Science and Technology Identifier: NCT01866241    
Other Study ID Numbers: MUST-17-2012
First Posted: May 31, 2013    Key Record Dates
Last Update Posted: September 8, 2014
Last Verified: September 2014
Additional relevant MeSH terms:
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Postpartum Hemorrhage
Maternal Death
Pathologic Processes
Obstetric Labor Complications
Pregnancy Complications
Puerperal Disorders
Uterine Hemorrhage
Parental Death
Abortifacient Agents, Nonsteroidal
Abortifacient Agents
Reproductive Control Agents
Physiological Effects of Drugs
Anti-Ulcer Agents
Gastrointestinal Agents