EFFICACY OF 600MCG OF MISOPROSTOL ORALLY VERSUS PER RECTAL IN THE ACTIVE MANAGEMENT OF 3RD STAGE OF LABOUR TO PREVENT 3RD STAGE PPH & ITS COMPLICATIONS

Abstract

Bathula Usha Rani1, Karuna Kumari2, Aruna Kumari3

The aim of the study was to define the efficacy of 600mcg of misoprostol orally versus per rectal in the active management of third stage of labour to prevent third stage PPH and other third stage complications; to evaluate the side effects of the drug and to study the incidence of PPH. MATERIALS AND METHODS: The present study was conducted at a tertiary referral centre in Government General Hospital, Kakinada during the period October 2011-October 2012. A total number of 200 cases of vaginal deliveries were included in this study. The patients were divided into two groups; in 100 cases misoprostol 600mcg was given orally and in 100 cases misoprostol was kept per rectally and the results compared. RESULTS: The mean duration of third stage in oral misoprostol group was 5.43ï?±2.15 minutes and in rectal misoprostol group was 3.91±1.63 minutes. The mean third stage blood loss in oral misoprostol group was 123.5 sec and in rectal misoprostol group was 73.15 sec. P value is <0.001, which was statistically significant. In the study in both groups pre delivery and post-delivery Hb% levels were in comparable range with mean fall in Hb% being 0.69±0.68 and 0.59±0.81 in oral and rectal misoprostol groups respectively. In both groups pre delivery hematocrit was between 30-30% and after delivery oral misoprostol group had that between 28-30% in 68% cases and in rectal group was 50% of cases between 30-35%. CONCLUSION: It was concluded that the rectal misoprostol used in third stage of labour immediately after delivery of the anterior shoulder is simple, safe, effective, non-invasive method requiring no extra effort, cost and assistance. The routine use of misoprostol should be made mandatory for improving women’s health in developing countries where most of the women are anemic before conception.

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