DISUSUN OLEH

SHINTA TANTRI AMANDA S. KED

2008730036
KEPANITERAAN KLINIK STASE OBSTETRI DAN GINEKOLOGI
RSIJ PONDOK KOPI

Pembimbing : Dr. H. M. Natsir Nugroho,Sp.OG, M.Kes

Misoprostol for postpartum hemorrhage : Moving from evidence to practice
Abstract Introduction Challenge to evidence-based use of misoprostol
Strategies for expanding access to evidence-based care Conclusion

Clinical and operational evidence indicates that

misoprostol is a safe and effective technology
for addressing postpartum hemorrhage
This research has not yet been translated into

effective policies.
The medical and health policy communities need
to work together to translate research findings
into changes in policy on the world's promise to
improve maternal health.
Misoprostol for postpartum hemorrhage : Moving from evidence to practice
Abstract Introduction Challenge to evidence-based use of misoprostol
Strategies for expanding access to evidence-based care Conclusion

In March 2011,
misoprostol was
added to the
WHO Model List Misoprostol is
of Essential a safe and
Millennium Medicines for the effective
Development prevention of option for
Goal (MDG) PPH preventing
5's and treating
PPH after
oxytocin
Misoprostol for postpartum hemorrhage : Moving from evidence to practice
Abstract Introduction Challenge to evidence-based use of misoprostol
Strategies for expanding access to evidence-based care Conclusion

Misoprostol

Oral
misoprostol Advantages
(600 g)
can
prevent
PPH Stable at room
temperature Growing body of research
Easy to store
Sublingual and administer
misoprostol Has yet to be translated into
Inexpensive
(800 g) is effective policies, programs, and practice
effective Widely inmany parts of theworld
available
treatment
Misoprostol for postpartum hemorrhage : Moving from evidence to practice
Abstract Introduction Challenge to evidence-based use of misoprostol
Strategies for expanding access to evidence-based care Conclusion

Use for a range of

indications

Misconceptions and Availability and

misperceptions registration of
misoprostol

Lack of evidence-
based guidelines and
provider training
Misoprostol for postpartum hemorrhage : Moving from evidence to practice
Abstract Introduction Challenge to evidence-based use of misoprostol
Strategies for expanding access to evidence-based care Conclusion

Women's heath indications for misoprostol.

Cervical priming
Induced abortion

Labor induction

Uterine evacuation after failed pregnancy

Prevention and treatment of PPH

Advocacy to improve the availability of misoprostol on a

national level may involve pursuing registration, promoting
inclusion on the national essential medicine list
Misoprostol for postpartum hemorrhage : Moving from evidence to practice
Abstract Introduction Challenge to evidence-based use of misoprostol
Strategies for expanding access to evidence-based care Conclusion

Evidence-based guidelines need to be put in

place at the national level, and supplemented
by training and on going education of
providers.

- Worry that promotion of

misoprostol for use in nonfacility deliveries
- Repurposed for use in medical
Abortion
- National obstetrics and gynecology
associations have played an important
advocacy role
Misoprostol for postpartum hemorrhage : Moving from evidence to practice
Abstract Introduction Challenge to evidence-based use of misoprostol
Strategies for expanding access to evidence-based care Conclusion
Misoprostol for postpartum hemorrhage : Moving from evidence to practice
Abstract Introduction Challenge to evidence-based use of misoprostol
Strategies for expanding access to evidence-based care Conclusion

Misoprostol has emerged as a promising technology

for addressing the global burden of PPH; however, we
must remember that it is not a panacea.
Misoprostol must be viewed as one strategy among
manyalbeit one that can help to address some of
the stubborn challenges faced by health systems and
facilities
We should keep our ultimate goal in sight: ensuring
that every woman has access to a uterotonic for
effective management of PPH
WASSALAMUALAIKUM
WR. WB
..........,.....Juni 2012