The level of evidence is downgraded by imprecision.
A Cochrane review «Uterotonic agents for first‐line treatment of postpartum haemorrhage: a network meta‐analysis»1 «Parry Smith WR, Papadopoulou A, Thomas E et al. Uterotonic agents for first-line treatment of postpartum haemorrhage: a network meta-analysis. Cochrane Database Syst Rev 2020;(11):CD012754. »1 included 7 studies with a total of 3738 subjects. In a pairwise meta-analysis of 2 trials (n=1787), misoprostol, as first-line treatment increased the risk of blood transfusion (RR 1.47, 95% CI 1.02 to 2.14), blood loss of 1000 mL or more (RR 2.57, 95% CI 1.00 to 6.64), and vomiting (RR 2.47, 95% CI 1.37 to 4.47) compared with oxytocin. Misoprostol plus oxytocin makes little or no difference to the use of additional uterotonics and to blood transfusion compared with oxytocin (4 trials, n=1881).