UMBILICAL VEIN INJECTION OF MISOPROSTOL VERSUS NORMAL SALINE FOR THE TREATMENT OF RETAINED PLACENTA IN A TERTIARY CARE CENTRE- A NON-RANDOMISED CONTROLLED TRIAL
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2017, Vol 6, Issue 60
Abstract
BACKGROUND Many cases of PPH are associated with retained placenta, having great impact on maternal mortality and morbidity worldwide. The aim of our study was to evaluate the efficacy of intraumbilical misoprostol versus normal saline injection as a treatment for retained placenta after vaginal delivery to reduce the incidence of manual removal of placenta and blood loss associated with it. MATERIALS AND METHODS It was a hospital-based, non-randomised controlled trial study carried out in the Department of Obstetrics and Gynaecology, Bankura Sammilani Medical College and Hospital, Bankura for one year period from April 2015 to March 2016. The study group of total 50 mothers received 800 mcg of misoprostol dissolved in 25 mL of normal saline and injected by Pipingas technique through umbilical vein. In control group, a total of 50 mothers received 25 mL NS injected by Pipingas technique through umbilical vein. Outcome measures were expulsion of the placenta, need for manual removal of the placenta under anaesthesia and amount of blood loss. RESULTS Total number of patients requiring manual removal of placenta in the entire study population (n= 100) was 26. Total 16% (n= 8) patients among misoprostol group (n= 50) underwent manual removal, while 36% (n= 18) of patients underwent manual removal of placenta in normal saline group (n= 50) which was statistically significant with p value < 0.05. In terms of duration of third stage of labour (time calculated after 30 mins) and amount of blood loss (mL), median values of both the parameters were less in misoprostol group than normal saline group and the results were statistically significant (p= 0.00). CONCLUSION Intraumbilical misoprostol is a promising tool for treatment of retained placenta; it acts by placing misoprostol directly to the placental bed. As per our study, we concluded that intraumbilical misoprostol significantly reduces the need for manual removal of placenta. The success rates were 84% (42/50) in intraumbilical misoprostol group compared to 64% (32/50) in saline group. The proportion of patients requiring manual removal of placenta in the intraumbilical misoprostol arm (8/50 patients, 16%) was lower than that in the intraumbilical saline arm (18/50 patients, 36%), (p value < 0.05).
Authors and Affiliations
Kajal Kumar Patra, Shibram Chattopadhyay, Amarnath Dey, Chaitali Sarkar, Anaindita Chakraborty, Shritanu Bhattacharyya
Keywords
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- EP ID EP226792
- DOI 10.14260/Jemds/2017/948
- Views 95
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