Misoprostol for prevention and treatment of postpartum hemorrhage: what do we know? What is next?

Misoprostol is an effective and safe uterotonic for the prevention and treatment of postpartum hemorrhage (PPH). A 600-μg oral dose of misoprostol has been shown to prevent PPH in community-based randomized controlled trials. An 800-μg sublingual dose of misoprostol appears to be a good first-line treatment for controlling PPH. Adverse effects after use of misoprostol for PPH prevention or treatment may include shivering and fever. These effects are transient, resolve on their own, and are not life threatening. Misoprostol can play an important role in settings with limited access to oxytocin, and where there is no other option for PPH care.