Role of complementary prophylactic use of misoprostol in prevention of PPH in high risk obstetric patients in KHUH, Bahrain

  • Samina Anwar Consultant, King hamad university hospital Bahrain
  • Ayesha Adeel Senior Registrar, King hamad University hospital Bahrain
  • Nawal Alabdullah King hamad University hospital Bahrain
  • Aisha Albinali King hamad University hospital Bahrain
Keywords: Postpartum haemorrhage, Uterine atonia, Misoprostol, AMTSL


Objective: The aim of the study was to find out women at risk of PPH received the complementary misoprostol apart from routine AMTSL and to find out the incidence of PPH in these cases.
Methodology The study was carried out at King Hamad University Hospital Bahrain from August 2016 - October 2017.Its a retrospective cohort study involving 450 Patients. Data collection from the medical record in the labour ward and operation theatre using Hospital management information system. A simple excel sheet was used. The data was fed to SPSS version 23.0 and statistically analyzed using chi square test to calculate “P” value. PPH is defined as blood loss of more than 500ml after a vaginal delivery or more than 1 liter after a caesarean section. It affects 2% of women giving births and kills more than 100,000 women per year globally. Uterine atony is the leading cause of immediate PPH (75–90 percent). In this study apart from AMTSL we added misoprostol per rectum with routine syntocinon to reduce the risk of PPH due to hypotonia.
Results The total number of cases studied were 450 and out of them 94 had PPH which is 2.6%.PPH due to hypotonia was n=58 (61%). Among 450 total 36 were excluded because of PPH due to other causes. Among 414 patients 356(85%) received misoprostol and 58(15%) did not receive misoprostol had PPH.PPH in patients who received misoprostol was only 0.8%.
Conclusion: The incidence of PPH is significantly higher in the group that did not receive Misoprostol compared to the group that received Misoprostol P<0.001.

Author Biographies

Ayesha Adeel, Senior Registrar, King hamad University hospital Bahrain


Obstetrics and gynecology.

Nawal Alabdullah, King hamad University hospital Bahrain


Obgyn department

Aisha Albinali, King hamad University hospital Bahrain

Year 4 resident


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