COMPARING THE EFFECTIVENESS OF TRANSRECTAL MISOPROSTOL WITH INTRVANEOUS OXYTOCIN IN PREVENTING POST PARTUM HAEMORRHAGE

Background:In India, the routine Active Management of Third Stage of Labour (AMTSL) with conventional oxytocin, at the rural, resource-constrained areas, is often compromised due to lack of trained healthcare personnel and proper maintenance of cold chain system, causing maternal mortality and morbidity from Postpartum Haemorrhage (PPH). In these scenarios, tablet misoprostol, can be efficacious and convenient alternative.

Aim: To compare the effectiveness of transrectal misoprostol with intravenous oxytocin in active management of third stage of labour in preventing PPH.

Materials and Methods: The study was conducted at AVBRH sawangi. 200 eligible pregnant women were randomised into two groups. Group A received 600mcg misoprostol and Group B received 10 IU oxytocin following delivery of baby as a part of active management of third stage of labour. primary outcomes measured were blood loss during third stage of labour, total blood loss within 24 hours following delivery of baby, occurrence of post partum haemorrhage (PPH). Secondary outcomes measured were duration of third stage of labour, requirement of additional uterotonics, change in haemoglobin concentration, requirement of blood transfusion, pre delivery and post delivery systolic and diastolic blood pressures, side effects of drugs.

Result: total sample size 200 was divided equally into two groups with a mean age of 25.34  3.72 and 25.65  3.85 respectively in misoprostol and oxytocin group. The mean blood loss during third stage of labour (134.73.7173.71 and 133 62.95) was statistically insignificant (p value=0.91). The mean blood loss 24 hours following delivery (209.11 108.59 and 207.02 93.92) was statistically insignificant (p value=0.88). The occurrence of PPH ( 2% and 1%) was statistically insignificant. (p value=0.56). duration of third satge of labour, requirement of additional uterotonics, change in haemoglobin concentration, requirement of blood transfusion, pre delivery and post delivery diastolic and systolic blood pressures were statistically insignificant between both the groups. There was no significant difference between the groups in terms of occurrence of nausea, vomiting and diarrhea. However, both groups differed significantly in terms of fever and shivering, they occurred more commonly in misoprostol group than oxytocin group.

Conclusion: This study concludes that transrectal misoprostol was as effective as intravenous oxytocin in active management of third stage of labour in preventing PPH.