PRIMARY POSTPARTUM HAEMORRHAGE

COMPARISON OF EFFECTIVENESS OF MISOPROSTOL AND SYNTOCINON IN THE PROPHYLAXIS

Abstract

Objective: To compare the effectiveness of Misoprostol with syntocinon in the prophylaxis of primary post partum haemorrhage during the management of 3rd stage of labour. Design: Experimental study. Setting: Department of Obstetrics & Gynaecology Sheikh Zayed Medical College/Hospital, Rahim Yar Khan. Patients and Methods: Pregnant patient with term pregnancy in labour were admitted in labour room. After confirmation that the patient is in labour, they were randomly divided in two groups A & B with 50 patients in each group. 600 ug oral Misoprostol was given to patients in group A and 10 units I/V Syntocinon were given to patients in group B at the time of delivery of anterior shoulder of the baby. Amount of blood loss was observed and all the information were recorded and entered in predesigned proforma. Results:
Amongst the 100 pregnant patients the mean age was 28.86 + 2.94 and mean parity of patients was 3.94. 57% of patients were presented with labour pains only and 27% presented with both labour pain and leaking liquor. In 59 patients duration of labour was between 2-12 hours. Total 9 patients develop PPH in both groups, three patients from Misoprostol group and six patients from syntocinon group. PPH was mild to moderate and settled down with other uterotonic drugs none of the patient required surgical intervention. Development of minor side effect was relatively high in Misoprostol group i.e. 10% such as nausea, vomiting while 4% in syntocinon group. Shivering and mild pyrexia was 12% in Misoprostol group while 5% in syntocinon group. Conclusion: In this study effectiveness of both syntocinon & Misoprostol has been found comparable Misoprostol being slightly more effective than syntocinon in managing 3rd stage of labour also prophylacticaly and it also has fewer minor side effects with no serious danger to life. It does not need skilled personnel for its use.