Role of Intaumbilical Misoprostol in Prevention of Postpartum Hemorrhage

M. Al-Jebory, Melal; K. Gata, Asmaa; J. Witwit, Suha

	Role of Intaumbilical Misoprostol in Prevention of Postpartum Hemorrhage
Kerbala Journal of Medicine
Article 11, Volume 3, Issue 6, 2010, Pages 840-849 PDF (0 K)
Authors
Melal M. Al-Jebory; Asmaa K. Gata; Suha J. Witwit
Abstract
Background: Prostaglandins have mainly been used for postpartum hemorrhage (pph) when other measures fail,misoprostol, a new and inexpensive prostaglandin E1 analougue,has been suggested as an alternative for routine management of he third stage of labour. Aim o the study: To determine the efficacy of intraumbilical oxytocin administration compared with intraumbilical misoprostol administration for prevention of postpartum hemorrhage. Materials and methods: Prospective study done at Babylon Hospital for Maternity and Pediatrics from February 2009 to September 2009. study involved 75 women in their 3rd. stage of labor subdivided into 3 groups 25 for each received either 30 i.u oxytocin in 30 ml saline or 800 mcg of misoprostol dissolved in 30 ml of saline 3rd group was control received only 30 ml of saline injected into the placental bed via umbilical vein using pipingas technique . The primary outcome measured was duration of 3rd stage of labor , amount of blood loss and need for manual removal of placenta. P-value of <0.01 considered statistically significant. Results: All groups are comparable in their demographic criteria. Intraumbilical injection of misoprostol associated with shorter duration of 3rd stage of labor (2.5 ± 0.2 min) compared with oxytocin group (3.5 ± 1.1 min) and control group (5.56 ± 2.2 min) p value <0.0001. Blood loss was comparable in both misoprostol and oxytocin group (31.6± 15 ml and 33.2±18.7 ml respectively, p-value >0.05) which was significantly lower than control group (147.1 ± 99 ml) p value <0.0001. No reported cases of retained placenta in both oxytocin and misoprostol groups compared with 2 cases (8%) in control group. Further uterotonic drugs required in 20% of control group. No significant side effects reported in all study groups. Conclusion: 1- Intaumbilical injection of 800 mcg misoprostol dissolved in 30 ml of saline using pipingas technique was more effective than intraumbilical oxytocin in shortening the duration of 3rd stage of labor and both reduce the incidence of postpartum hemorrhage. 2- the intraumbilical injection of uterotonics is non- invasive ,effective and clinically safe method for management of 3rd stage of labor and prevention of postpartum hemorrhage.

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