A COMPARATIVE RANDOMIZED CONTROLLED TRIAL OF MISOPROSTOL PER RECTAL AND MISOPROSTOL PER ORAL IN THE ACTIVE MANAGEMENT OF THIRD STAGE OF LABOUR

Smitha K; Venky

Volume : IX, Issue : VIII, August - 2019

A COMPARATIVE RANDOMIZED CONTROLLED TRIAL OF MISOPROSTOL PER RECTAL AND MISOPROSTOL PER ORAL IN THE ACTIVE MANAGEMENT OF THIRD STAGE OF LABOUR

Smitha K, Venky

Abstract :

Background : Postpartum haemorrhage, which is still one of the commonest causes of maternal mortality in the developing countries has been largely reduced in the developed countries by active management of third stage of labour (AMTSL). Aim : To compare the efficacy and safety of Misoprostol 600 mcg per rectal with Misoprostol 600 mcg per oral in the active management of third stage of labour (AMTSL) Materials and methods : a total of seventy patients of 34 to 42 weeks of gestation delivering vaginally satisfying inclusion and exclusion criteria in St. Martha’s Hospital were selected for the study. They were randomly allocated into two groups. Group A included 35 patients and were given Tab Misoprostol 600 mcg per oral, Group B included 35 patients and were given Tab Misoprostol 600 mcg per rectal as a part of AMTSL. Results : In the oral misoprostol group mean duration of third stage of labour was 5 minutes and 32 seconds, mean blood loss was 180.14ml and mean haemoglobin difference was 0.35 g/dl whereas in the rectal misoprostol group mean duration was 4 minutes and 50 seconds, mean blood loss was 120.43ml and mean haemoglobin difference was 0.24g/dl. All these observations were statistically significant (P < 0.05). In the study totally 4 patients had PPH, 3 in oral misoprostol group and 1 patient in rectal misoprostol group and is not significant statistically (P>0.05). All were managed with additional oxytocics. Side effects were more in the oral misoprostol group compared to rectal misoprostol group. Conclusion : Misoprostol can be used effectively in the AMTSL for the prevention of PPH through different routes especially in non–institutional deliveries and in places of low resource settings. The mean duration of third stage of labour, the mean blood loss and the incidence of PPH are significantly less if Misoprostol is used through rectal route compared to the oral route. Side effects which is a major concern with oral misoprostol, can be significantly ought down if misoprostol is administered through rectal route.