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  3. 3. A Randomized Controlled Trial on Prevention of Postpartum Haemorrhage with Sublingual Misoprostol or Oxytocin
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3. A Randomized Controlled Trial on Prevention of Postpartum Haemorrhage with Sublingual Misoprostol or Oxytocin

1. Kulsoom Bhatti 2. Tahmina Mahar 3. Rubeena Hafeez 4. Shoaib-u-Nisa

1. Asstt. Prof., 2, 3, 4. Senior Registrars, Department of Obstetrics & Gynecology,  Ghulam Muhammad Mahar Medical College Sukkur.

ABSTRACT

Introduction: Failure of the uterus to contract adequately after child birth (a tonicity) is the most common cause of postpartum hemorrhage and misoprostol produces a rapid peak concentration, and is more effective than oral administration.

Objective: We compared the postpartum blood loss with 400µg sublingual misoprostol and after standard care using 10 iu intramuscular oxytocin. Study Design: Randomized controlled trial.

Place and Duration of Study: This study was conducted in a Department of Obstetrics and Gynecology Ghulam Muhammad Mahar Medical College Teaching Hospital Khairpur Sindh during 2011.

Materials and Methods: 60 women for each group were assigned to receive the study medications with in 1 minute of clamping and cutting the cord. Chi-square and studentt-test were used to test categorical and continuous outcomes. Mean postpartum blood loss and PPH (>500ml), >10% pre- to postpartum decline in hemoglobin and reported side effects.

Results: The mean estimated blood loss with sublingual misoprostol was 200± 125ml (n=60) and 360±136ml with oxytocin (n=60) P-value ≤ 0.001.The incidence of PPH was 3.3% with misoprostol and 6.6% with oxytocin group. No women lost >1000 ml of blood. Hemoglobin decline of > 10% observed that 11.6% and 45.0% in women after receiving misoprostol and oxytocin (P≤ 0.001). Side effects were significantly greater in the misoprostol group than in the oxytocin group.

Conclusion:  In this trial we found sublingual misoprostol more effective than intramuscular oxytocinin reducing PPH, with only transient side effects.

Key Words: Hemoglobin, misoprostol, oxytocin, Postpartum hemorrhage, sublingual.