Since Nigeria officially registered misoprostol for use for postpartum hemorrhage prevention in 2006, the following countries have followed suit: Tanzania, Bangladesh, Zambia, Ghana, Uganda, Kenya, Nepal, Sudan, Somaliland, Mozambique, Pakistan, and Sierra Leone.
May 21, 2011: *** This month misorpostol was added to the WHO List of Essential Medicines for the prevention of postpartum hemorrhage (PPH). “600 micrograms [misoprostol] given orally is effective and safe for the prevention of PPH” in settings where oxytocin, currently the standard of care to prevent PPH, is not available or feasible."
Misoprostol is a low-cost, off-patent drug that is now being used in some settings to prevent postpartum hemorrhage. Its other core features are that it does not require refrigeration--it is an evidence-based alternative to oxytocin and ergometrine, which both require cold chain--and that it is taken orally and so can be administered by all kinds of providers. Nigeria is the first country to register misoprostol for use for postpartum hemorrhage prevention.
The full proposal to the WHO for inclusion in the Essential Medicines List was submitted by Gynuity Health and Venture Strategies for Health and can be found here: http://www.who.int/selection_medicines/committees/expert/17/application/... It is an excellent summary of the literature and the need for misoprostol. Note that the WHO has not yet accepted misoprostol for prevention of pph in the field yet.
Nigeria is the first country to register misoprostol for use for postpartum hemorrhage prevention.Web Design