POST PARTUM HAEMORRHAGE PROPHYLAXIS

COMPARISON OF THE EFFICACY OF MISOPROSTOL AND ERGOMETRINE IN CESARIAN DELIVERY

Abstract

Post partum hemorrhage (PPH) is defined as the loss of greater than 500ml of blood from the genital
tract in the first 24 hours following delivery. PPH occurs in 2-11% of all deliveries. Objective: To compare the efficacy
of misoprostol and ergometrine for the prophylaxis of Post Partum Haemorrhage. Design: Prospective study. Setting:
Gynaecology and Obstetrics Department Military Hospital Rawalpindi. Period: From 01 July 2006 to 31 Dec 2006.
Patients & Methods: A total of 200 patients were recruited in the study, they were divided in two groups, group – I (n100) included those patients who were administered ergometrine intravenously at the time of delivery of head for the
prophylaxis of post partum haemorrhage, Group – 2 (n-100) included those patients who were administered Misoprostol
800 microgram per rectally just before the start of cesarean section for the same purpose. Blood loss was calculated
objectively by squeezing the soaked pads and quantifying the amount of clots in a kidney tray of standard size to be
equal to 500ml.Results: In group I (n-100) 15 patients had mild PPH blood loss >500ml, out of them 03 had severe
PPH requiring bimanual message and 02 patients required blood transfusion, in group II( n-100). 08 patients had PPH,
blood loss >500 ml, out of them 01 patient required uterine message and none required blood transfusion. Chi-square
test was applied to compare the efficacy of the two groups, P>0.05 showed no significant difference in the efficacy of
the two groups but the side effects were obviously less in the Misoprostol group. No patient in group II had GI symptoms
while 36 patient in group I had retching and, vomiting and 03 patients had raised B.P after the administration of
ergometrine. Conclusion: Misoprostol administered per rectally has equal efficacy to ergometrine given intravenously
for the prophylaxis of post partum haemorrhage but the side effect profile and patient tolerability is better with
Misoprostol.