Misoprostol - prevention and treatment of postpartum hemorrhage (based on FIGO-2018 Congress)

In 2016 FIGO conducted a global study to determine the drug provision of clinical guidelines for the management of postpartum hemorrhages in 130 countries of the world. A number of questions was associated with misoprostol because it is available and inexpensive drug in convenient tablet form, does not require any special skills, equipment, or facilities for its use and when oxytocin is not available, misoprostol is effective for prevention and treatment of postpartum hemorrhages. At the end of the study, responses were received from 69 countries.

19% of respondents reported that their country do not have national guidelines on PPH management. Of countries that do, guidance on misoprostol use is often absent (just 59% of reported guidelines include misoprostol for prevention and treatment of PPH).

In most countries misoprostol is absent in the Registers of essential drugs, despite WHO recommendations about the use of this drug as a means of prevention (since 2011) and treatment of postpartum bleeding (since 2015).

The development of national recommendations based on evidence-based medicine and inclusion of misoprostol in essential drug registries are key measures to address by countries problems of maternal morbidity and mortality associated with postpartum hemorrhages.