INTRAMUSCULAR OXYTOCIN VERSUS SUBLINGUAL MISOPROSTOL AS A COMPONENT OF ACTIVE MANAGEMENT OF THIRD STAGE OF LABOUR FOR PREVENTION OF PRIMARY POST-PARTUM HAEMORRHAGE
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 28
Abstract
BACKGROUND Post-partum haemorrhage is one of the common causes of maternal mortality and morbidity worldwide. Active management of labour is the key element in prevention of post-partum bleeding and complication of third stage of labour. Use of uterotonics is mandatory for prevention of primary post-partum haemorrhage. Many drugs like oxytocin, misoprostol, ergometrine alone or in combination are used as uterotonic drugs. Our aim is to compare the efficacy and safety of intramuscular oxytocin and sublingual misoprostol as an uterotonic agent used to minimise post-partum bleeding. MATERIALS AND METHODS 800 selected antenatal mothers fulfilling the inclusion and exclusion criteria were divided non-randomly into two equal groups of 400 each by using computerised generated randomisation chart. One group received 400 mcg of sublingual misoprostol and the other group received intramuscular oxytocin after the delivery of the baby as a component of active management of third stage of labour for prevention of primary atonic PPH. The efficacy and side effects of the two drugs were assessed. This study found both sublingual misoprostol and intramuscular oxytocin to be effective in prevention of primary PPH with oxytocin being slightly better than misoprostol, but those with misoprostol had significantly higher incidence of fall of haemoglobin and PCV and significantly higher incidence of fever. Hypotension, though more common with oxytocin, was not found to be significantly higher than in patients treated with misoprostol. On the contrary, mean fall of SBP and DBP was significantly more in the misoprostol group. This study established that both misoprostol and oxytocin are equally effective in prevention of primary PPH with oxytocin slightly better than misoprostol. Misoprostol can be used as an alternative to oxytocin in low resource areas. Both oxytocin and misoprostol are capable of minimising blood loss in 90% of the individuals. RESULTS This study found both sublingual misoprostol and intramuscular oxytocin to be effective in prevention of primary PPH with oxytocin being slightly better than misoprostol, but those with misoprostol had significantly higher incidence of fall of haemoglobin and PCV and significantly higher incidence of fever. Hypotension, though more common with oxytocin was not found to be significantly than those treated with misoprostol. On the contrary, mean fall of SBP and DBP was significantly more in the misoprostol group. CONCLUSION This study established that both misoprostol and oxytocin are equally effective in prevention of primary PPH with oxytocin being slightly better than misoprostol. Misoprostol can be used as an alternative to oxytocin in low resource areas. Both oxytocin and misoprostol are capable of minimising blood loss in 90% of the individuals
Authors and Affiliations
Sukumar Mitra, Jhumee Baraik
Keywords
Related Articles
- EP ID EP537848
- DOI 10.14260/jemds/2018/721
- Views 76
- Downloads 0
INTESTINAL PARASITIC INFECTION IN SCHOOL GOING CHILDREN IN KATIHAR, BIHAR
BACKGROUND Intestinal parasitic diseases constitute a global health burden in numerous developing countries, mainly due to faecal contamination of water and food and represents a major cause of morbidity and mortality in...
A STUDY ON ULTRASOUND ASSISTED CANNULATION OF THE INTERNAL JUGULAR VEIN IN COMPARISON TO THE HIGH APPROACH EXTERNAL LANDMARK GUIDED TECHNIQUE
BACKGROUND Ultrasound has been a valuable tool in diagnostic and therapeutic practice in Emergency and Critical care situations. Since its first use for Central Venous access in 1978, where it was used for marki...
FOURNIER’S GANGRENE: EXPERIENCE IN A TERTIARY CARE HOSPITAL- A RETROSPECTIVE ANALYSIS OF 288 PATIENTS
BACKGROUND Fournier’s gangrene (FG) is a rare but life-threatening disease. Although originally thought to be an idiopathic process, FG has been shown to have a predilection for patients with diabetes as well as longterm...
GENERALIZED PERITONITIS WITH UTERINE INCISION NECROSIS WITH DEHISCENCE FOLLOWING CESAREAN SECTION PRESENTING AS GENITOURINARY FISTULA: A UNIQUE COMPLICATION
Generalized peritonitis following lower segment caesarean section with uterine incision necrosis and dehiscence presenting as genitourinary fistula is very unusual. Herein we report a case of 28 years old woman who w...
STUDY OF THE EFFECTS OF SILVER NITRATE IN TREATMENT OF ALLERGIC RHINITIS
BACKGROUND Rhinitis is defined as the presence of at least one of the following: congestion, rhinorrhoea, sneezing, nasal itching and nasal obstruction. Other reported symptoms include throat clearing, headaches, facial...