Misoprostol versus
Oxytocin for
the Prevention of
Postpartum
Hemorrhage
Post Partum
Hemorrhage
It
may
be
defined
as
500mL
hemorrhage after vaginal or 1000mL
hemorrhage after CS delivery..
METHOD
double-blind randomized controlled trial
The inclusion criteria were women with singleton pregnancy with
cephalic presentation who had NVD spontaneously or by induction.
The exclusion criteria were placenta previa (based on ultrasound
sonography in the third trimester), placental abruption, coagulation
problems, previous CS, macrosomia, polyhydramnios , and
uncontrolled asthma.
400 pregnant
1:
1. Thewere
primary outcome was hemorrhageGroup
(quantified
blood loss)
Women
20 IU oxytocin in 1000mL Ringers solution at a rate
randomly
within 1 hour of delivery;
of 600 mL/hr plus placebo misoprostol tablet (group
assigned
to onesecondary
of
2. The
outcomes were hematocrit (HCT) and
1: routine management for prevention of PPH)
two
groups
hemoglobin (Hb) 24 hours after delivery, hemodynamic
Groupand
2 : drug-adverse
instability within 24 hours after delivery,
400
g oral chills
misoprostol
as the
alternative
active
effects, including fever
(38C),
(reported
by the
patient),
management of the third stage of labour plus
diarrhea, nausea, vomiting,and hypotension.
placebo oxytocin in 1000mL Ringers solution at a
rate of 600mL/hr for prevention of PPH
To calculate this, the pads which were used after NVD were weighed before
usage and after usage (after absorbance of blood). By this method we
obtained the blood loss amount in grams.
RESULT
400
pregnant
women
were
included in
the study.
200
patients
were
included in
each group.
The mean
age of the
study
participants
was 25.86
5.79 years.
DISCUSSION
In this study we
compared the safety
and efficacy of
misoprostol and
oxytocin in the
prevention
of PPHwith the
This finding
is compatible
finding of the study by Lokugamage et
al. who reported the superiority of
misoprostol over Syntometrine in
managing PPH
CONCLUSION
Our study suggests that the use of misoprostol is more effective for
decreasing the amount of blood loss, thereby avoiding a PPH, and is
associated with mild and selflimiting
side effects. Misoprostol is cost effective and easily administered and
therefore may be considered for use in low resource areas when
oxytocin is unavailable.
TERIMA KASIH