High fever after sublingual administration of misoprostol for treatment of postpartum hemorrhage: A hospital-based, prospective observational study in Argentina

Tropical Medicine & International Health : TM & IH
J DurocherBeverly Winikoff

Abstract

To characterize the occurrence of fever (≥38.0°C) after treatment for postpartum hemorrhage (PPH) with sublingual misoprostol 800 mcg in Latin America, where elevated rates of misoprostol's thermoregulatory effects and recipients' increased susceptibility to high fever have been documented. A prospective observational study in hospitals in Argentina enrolled consenting women with atonic PPH after vaginal delivery, eligible to receive misoprostol. Corporal temperature was assessed at 30, 60, 90, and 120 minutes post-treatment; other effects were recorded. The incidence of high fever ≥40.0°C (primary outcome) was compared to the rate observed previously in Ecuador. Logistic regressions were performed to identify clinical and population-based predictors of misoprostol-induced fever. Transient shivering and fever were experienced by 75% (37/49) of treated participants, and described as acceptable by three-quarters of women interviewed (35/47). The high fever rate was 12% (6/49), [95% Confidence Interval (CI) 4.6, 24.8], compared to Ecuador's rate following misoprostol treatment (35.6% (58/163) [95% CI 28.3, 43.5], p=0.002). Significant predictors of misoprostol-induced fever (model dependent) were: pre-delivery hemoglobin <11.0g/dL...Continue Reading

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Methods Mentioned

BETA
hysterectomy
hysterectomies

Clinical Trials Mentioned

NCT02163616

Software Mentioned

Statistical Package for the Social Sciences

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