SUBLINGUAL MISOPROSTOL VS INTRA MUSCULAR OXYTOCIN COMPARATIVE STUDY - TO MINIMIZE BLOOD LOSS IN 3RD STAGE OF LABOUR

Dr. Vijayalakshmi.A; Dr. S.Chandrakala

Volume : VIII, Issue : II, February - 2019

SUBLINGUAL MISOPROSTOL VS INTRA MUSCULAR OXYTOCIN COMPARATIVE STUDY - TO MINIMIZE BLOOD LOSS IN 3RD STAGE OF LABOUR

Dr. Vijayalakshmi. A, Dr. S. Chandrakala

Abstract :

Objective: To compare the efficacy of sublingual use of misoprastol 400µg with intra muscular use of 10units of oxytocin to minimize the blood loss in 3rd stage of labour. Materials and Methods: This prospective randomized controlled trial was carried with 120 pregnant women admitted in our OG department and they was randomized into 2 groups. 60 women in each group. Group A received 10 units of oxytocin intramuscularly and in Group B received 400µg of Misoprostol sublingually, immediately after delivery of the baby. The primary outcomes were measured in the form of amount of blood loss and fall of haemoglobin levels. Secondary outcome were measured for need of uterotonics, duration of 3rd stage of labour, manual removal of placenta, blood transfusion, PPH and side effects of the drugs. Results: The mean fall in haemoglobin was 1.08 + 0.5 gms in oxytocin and 1.16 + 0.64 gms in misoprostol group. This was statistically not significant. The amount of blood loss in oxytocin group was 200 + 202 ml and in misoprostol group was 194 + 181ml, which was also statistically insignificant. 10% of women in oxytocin group and 8.4% of women in misoprostol group needed additional uterotonics. Shivering and fever (>38oC) were more common side effects in misoprostol group (8.3% in misoprostol and none of the women in oxytocin group). Conclusion: This study concluded that use of sublingual misoprostol to reduce the blood loss in 3rd stage of labour is equally effective as intra muscular use of oxytocin. It can be used as an alternative to oxytocin in developing countries, where most of the deliveries are conducted by birth attendants and where it is difficult to maintain cold chain. Although shivering and pyrexia are more common side effects, they were transient.