Community-Based Availability of Misoprostol: Is It Safe?

Ndola Prata, Godfrey Mbaruku, Amy A. Grossman, Martine Holston, Kristina Hsieh

Abstract

This paper evaluates the safety and acceptability of long-term community-based use of misoprostol for management of postpartum hemorrhage (PPH) in home-births, by comparing deliveries with and without misoprostol use in communities of Kigoma, Tanzania.   We administered a standardized survey instrument to women who delivered between August 2004 and May 2007.  940 women completed questionnaires, corresponding to 950 deliveries.  Findings showed that the majority of TBAs administered misoprostol at the correct time (76%).  Receipt of three or five tablets was most commonly reported (47% and 43% respectively).  Misoprostol users were significantly more likely to experience shivering, high temperature, nausea, and vomiting after delivery; adjustment for gynecological history and delivery characteristics revealed no significant differences in experience of symptoms.  Misoprostol was highly acceptable to all women surveyed.  Misoprostol at the community level is a safe intervention

(Afr J Reprod Health 2009; 13[2]:117-128).

 

RĖSUMĖ

Disponibilité de misoprostol dans la communauté : Est-il sans danger? Cet article évalue la sauveté et l’acceptabilité de l’emploi à long terme de misoprostol dans la communauté pour le traitement de l’hémorragie du post partum (HPP) dans les naissances à domicile, en comparant les accouchements avec et sans l’utilisation de misoprostol dans les communautés de Kigoma, Tanzamie.  Nous avons administré un instrument d’enquête standardisé aux femmes qui ont accouché entre le mois d’août 2004 et mai 2007.  940 femmes ont rempli des questionnaires, ce qui correspondait à 950 accouchements.  Les résultats ont montré que la majorité des sages-femmes traditionnelles (SFTs) ont administre misoprostol comme il faut (76%).  Elles ont indiqué en général avoir reçu trois ou cinq comprimés (47% et 43% respectivement).  Les utilisateurs de misoprostol avaient la possibilité de subir le frissonnement, la haute température, la nausée et le vomissement après l’accouchement ; l’ajustement pour l’histoire gynécologique et les caractéristiques de l’accouchement n’ont pas révélé des différences significatives quant aux symptômes.  Misoprostol a été bien acceptable à toutes les femmes enquêtées.  Misoprostol au niveau de la communauté est une intervention sans danger (Afr J Reprod Health 2009; 13[2]:117-128).

 

 

KEYWORDS: Misoprostol; Postpartum hemorrhage; Traditional birth attendants; Community-based; safety; Acceptability

 

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