Dose and side effects of sublingual misoprostol for treatment of postpartum hemorrhage: what difference do they make?

Background: Shivering and fever are common side effects of misoprostol. An unexpectedly high rate of fever above 40°C was documented among Ecuadorian women given treatment with 800mcg of sublingual misoprostol to manage postpartum hemorrhage (PPH) (36%). Much lower rates have been reported elsewhere (0-9%).

Oral misoprostol for the management of incomplete abortion in Ecuador.

Objective: To assess the feasibility of introducing misoprostol for the treatment of incomplete abortion in Quito, Ecuador.

Methods: In a randomized prospective study conducted at a large tertiary-level maternity hospital and a private secondary-level clinic between November 2006 and November 2007, women with incomplete abortion were treated with either 600 μg of oral misoprostol (n=122) or manual vacuum aspiration (MVA) (n=120). All participants were requested to return for follow-up care on day 7 to determine the success of the treatment and to document their satisfaction with the method and the adverse effects experienced.