Table 1 Administration of uterotonics. Self-administered, by TBAs, auxiliary midwives or community health workers: RR (95% CI) for PPH (n = 13)
From: Task shifting in active management of the third stage of labor: a systematic review
Study (first author, year of publication) | Design | Location | Deliveries (N per group) | Population (age, parity, education)a | PPH (%) | RR (95% CI) |
|---|---|---|---|---|---|---|
Misoprostolb, self- administered | ||||||
Geller et al., 2013 [22] | Quasi exp. trial | 30 communities in Ghana | 102 (82) misoprostol, 107 (92) control | Age: 26.6 ± 6.7 Parity(2–4): 46% Education: n/a | Misoprostol 1.2% (1/82), Control 3.3% (3/92) | 0.38 (0.04–3.57) |
Mir et al., 2012 [31] | Quasi exp. trial | Districts of Dadu and Khanewal, India | 678 (678) misoprostol, 720 (720) control | Age: 28 ± 5.7 Parity: n/a No education: 73% | Misoprostol (3/678) 0.4%, Control (n = 5/720) 0.6% | 0.42 (0.08–2.18) |
Misoprostol, TBAs | ||||||
Mobeen et al., 2010 [17] | RCT | 46 villages in Chitral, Pakistan | 533 (514) misoprostol, 583 (558) control | Age: 28 ± 5 Parity (3–5): 42.4% No education: 72.7% | Misoprostol 16.5% (85/514), Control 21.9% (122/558) | 0.76 (0.59–0.97) |
Prata et al., 2009 [32] | Quasi exp. trial | Rural villages of Tigray, Ethiopia | 485 (485) misoprostol, 481 (481) control | Age: 27.7 ± 6.7 Parity: 3.4 ± 2.0 No education: 80.2% | Misoprostol 8.9% (43/485), Control 18.9% (91/481) | 0.47 (0.33–0.66) |
Walraven et al., 2005 [11] | RCT | 26 villages of the North Bank East Health Division, The Gambia | 629 (629) misoprostol + 4 placebo tablets, 599 (599) ergometrinec + 3× placebo | Age: 25.9 ± 5.3 Parity(≥6): 18.6% No education: 95.2% | Misoprostol 11.0% (69/629), Ergometrine 12.0% (72/599) | 0.91 (0.67–1.25) |
Misoprostol, TBAs or self-administered | ||||||
Ejembi et al., 2014 [30] | Quasi exp. trial | 5 communities in North-West Nigeria | 1239 (1239) misoprostol, 231 (231) control | Age, parity, education: n/a | Misoprostol 8.1% (100/1239), Nothing 9.5% (22/231) | 0.84 (0.54–1.30) |
Prata et al., 2012a [33] | Quasi exp. trial | 5 communities in North-West Nigeria | 1421 (1421) misoprostol, 303 (303) control | Age, parity, education: n/a | Misoprostol 1.2% (17/1421) Nothing 7.6% (23/303) | 0.16 (0.09–0.31) |
Misoprostol, auxiliary midwives | ||||||
Chandhiok et al., 2005 [27] | Cluster-RCT | 30 PHCs from 5 states in India | 600 (600) misoprostol, 600 (600) standard (methergined/ nothing) | Age:24.3 ± 3.6, Gravida (2–3): 56.3%, Literate: 62% | Misoprostol 0.7% (4/600), Control 0.8% (5/600) | 0.80 (0.22–2.96) |
Derman et al., 2006 [28] | RCT | 4 PHCs of Belgaum district, India | 812 (809) misoprostol, 808 (807) placebo | Age:23.3 ± 3.3 Parity (1–2): 58.1% Literacy: 62.9% | Misoprostol 6.4% (52/809), Control 12.0% (97/807) | 0.53 (0.39–0.74) |
Oxytocine, auxiliary midwives | ||||||
Low et al., 2008 [34] | Quasi exp. trial | Public birth center in Morazan, Honduras | 146 (146) oxytocin, 83 (83) control | Age:23.5 Parity (1–4): 49.2% Education: n/a | Oxytocin 12.3% (18/146), No oxytocin 19.3% (16/83) | 0.64 (0.35–1.19) |
Low et al., 2012 [35] | Quasi exp. trial | Public birth center in Morazan, Honduras | 339 (339) intervention, 229 (229) pre-intervention | Age: 23.1 ± 6.5, Parity: 1.5 ± 2.1 Education: n/a | Intervention 5.9% (20/339), Pre-intervention 14.8% (34/229) | 0.40 (0.23–0.67) |
Misoprostol 2x200mcg, community health worker | ||||||
Nasreen et al., 2011 [36] | Quasi exp. trial | 2 districts, northern Bangladesh | 884 (884) misoprostol, 1008 (1008) control | Age:23.0 ± 4.8 Gravida: 2.6 ± 1.4 vs 2.1 ± 1.2 No education: 36.1% vs 21.2% | Misoprostol 1.6% (14/884), Control 6.4% (65/1008) | 0.25 (0.14–0.43) |
Oxytocin uniject device, community health worker | ||||||
Stanton et al., 2013 [29] | Cluster RCT | 4 rural districts in Brong-Ahafo region, Ghana | 689 (682) oxytocin 888 (888) control | Age: 27.5 ± 6.6. Parity(2–4): 43.3% No education: 48% | PPH-1:f 2.6% (18/682) vs 5.5% (49/887) PPH-2: 3.8% (26/682) vs 10.8% (96/887) PPH-3: 4.1% (28/682) vs 11.1% (99/888) Severe PPH 0.1% (1/682) vs 0.9% (8/887) | PPH-1: 0.49 (0.27–0.88) PPH-2: 0.34 (0.18–0.63) PPH-3: 0.36 (0.20–0.66) Severe PPH: 1 (0.013–1.7) |