PROPHYLACTIC USE OF MISOPROSTOL FOR THE PREVENTION OF POSTPARTUM HAEMORRHAGE AND ATONIC UTERUS IN CESARION SECTION DELIVERIES.
DOI:
https://doi.org/10.52206/jsmc.2016.6.2.785-789Abstract
BACK GROUND: Post partum hemorrhage still remains a major cause of maternal death. Syntocinon
is the first line protective measure in this regard. However this is heat sensitive and losses its efficacy
after storage for some time. On the other hand misoprostol do not losses its efficacy for long time after
storage, is cheap, can be stored at room temperature and give the same result as syntocinon in preventing
postpartum hemorrhage and atonic uterus.
OBJECTIVE: To assess the prophylactic use of misoprostol in preventing PPH and management of
atonic uterus, and compare it with conventional i/v syntocinon routinely used in hospitals for cesarion
deliveries.
MATERIAL AND METHODS: This is a semi experimental study, which was conducted in Mardan
medical complex Hospital Mardan, department of obstetrics and gynecology unit A, between May 2014
to May 2015. 200 women have give birth to their babies by C-section were included in the study and
divided into 2 groups, a control group (100 women who received syntocinon) and a study group (100
women who received rectal misoprostol). Syntocinon lOu i/v injection and misoprostol 800ug (4tablets)
per rectum were given to women in control and study group respectively, immediately after delivery of
the baby. Blood loss after delivery and frequency of atonic PPH were recorded and compared between
the two groups. Side effects of both drugs were also noted.
RESULTS: There was no significant difference in blood loss after delivery. Control group 250ml, study
group 300ml, P value -0.18). The frequency of atonic PPH in study and control groups was similar
ranging between 3% and 4%.Side effects of misoprostol ( shivering 25% , fever 15% , vomiting 12%
and diarrhea 5%) were significant ( P value <0.05 ) but all were temporary and not life threatening.
CONCLUSION: Misoprostol can be used for the prevention of PPH and to reduce atonic uterus after
C-section deliveries, especially in poor countries where facilities for storage of oxytocin are not
available. Benefits of misoprostol outweigh its side effects.
Key Words: prophylaxis, atonic postpartum hemorrhage, rectal, misoprostol, syntocinon,
underdeveloped countries.
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