In 2003-2005, around 9 in every 100,000 women who gave birth in the UK died through subsequent postpartum haemorrhage.1 In Africa and Asia, this complication is the commonest cause of maternal mortality, accounting for over 30% of such deaths in 1997-2002.2 These outcomes highlight the need for effective preventive and treatment strategies for postpartum haemorrhage. One possible option in this setting is the off-label use of misoprostol, a synthetic prostaglandin E1 analogue licensed for prevention and treatment of gastrointestinal ulcers. This drug is used in obstetric and gynaecological practice because of its uterotonic and cervical priming actions.3,4 Here we consider misoprostol as prevention of and treatment for postpartum haemorrhage.
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