Effectiveness of per rectal misoprostol for prevention of primary post-partum hemorrhage

Abstract

Objective: To determine effectiveness of per rectal misoprostol for prevention of primary post-partum hemorrhage.

Study Design: Interventional – Randomized Controlled Trail.

Setting: Department of Obstetrics & Gynecology, Abbottabad International Medical College, Abbottabad¹ and The Department of Obstetrics & Gynecology, Women Medical College, Abbottabad, and Women & Children Hospital Abbottabad.

Duration of Study: Jan 2024 to June 2024.

Subjects and Methods: One hundred and twenty female patients divided into two equal group.

Results:

The result revealed that total duration of labor is 11 hours ±4 and the blood lose was 610 ml ±318 in two group, There were difference in the management outcome and additional management techniques, in management out come PPH was controlled in  95 % patients ( 57 patient), in additional management no further treatment was given in 90 %  (54) patients. Exploration was required in 6.7 % (4) patients, Average Haemoglobin in the treatment group was 9.6 to 10.2 g/dl, In the treatment group, 46.7 % (28) patients were primigravida, 40 % (24) patients were  Multigravidas (Para 1-4) and 13 % (8) patients were Grandmultigravida (Para >4)

Conclusion:

The use of 400–600 micrograms of misoprostol as part of active management of third state of labor (AMTSL) is supported by scientific data in the prevention of PPH. The common procedures for the treatment of post partum haemorrhage are 800 microgram rectally. The rectal route takes longer to fully absorb but prolonged duration. It is thermo-stable and relatively cheap. The primary adverse effects, which vary on dosage, are pyrexia and shivering.

Keywords: PPH, Misoprostol, prevention, estimation