Post partum haemorrhage is a leading cause of maternal death in Malawi. If available, Oxytocin can be injected after delivery of the baby to reduce the risk of haemorrhage. Oxytocin is injected intravenously, and thus requires venous access and skilled birth attendants. Misoprosol can be administered sublingually and thus could be given by birth attendants ina variety of environments. A recent trial published in the Lancet, based on work from Burkina Faso, Egypt, Turkey and Vietnam showed the two treatments to be equally effective. Has anyone experience of using sublingual Misoprostol in Malawi?
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I don’t have experience nor do I know of any studies, but I do know of an organization in the US that partners with OB/GYNs in developing countries to make Misoprostol more widely available. They have been supportive of training OB/GYNs and midwives of its use and also in collecting outcome data. I don’t see from their web site that they’ve done work in Malawi, but that might be an opportunity to broach with them. They have done work in Tanzania.
http://www.venturestrategies.org/projects/index.php?status=current&id=k2o2xd_1j463c