COMPARISON OF INTRAUTERINE VERSUS PER-RECTAL MISOPROSTOL IN THE PREVENTION OF POSTPARTUM HAEMORRHAGE DURING CAESAREAN SECTION
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Keywords
Postpartum hemorrhage, misoprostol, intrauterine, per-rectal, cesarean section.
Abstract
Introduction: Postpartum Hemorrhage, or PPH, is one of the most common causes of maternal mortality and morbidity, mostly in the developing world. Misoprostol is a dry prostaglandin E1 analog that is commonly used for the preve ntion of PPH. However, the practical route of administration during cesarean sections is still debatable.
Objectives: To comparatively determine whether intrauterine and per-rectal misoprostol are more effective and safer for the prevention of PPH during cesarean sections.
Materials and Methods: The quantitative study designed in this research was a randomized controlled trial conducted at Khyber Teaching Hospital Peshawar, Pakistan with 200 samples, where only females with planned cesarean sections were selected. To facilitate the procedure, participants was given 600 mcg of misoprostol through intrauterine or per-rectal approach. The amount of blood loss, the hemoglobin concentrations, and the side effects were evaluated.
Results: Compared to the control group, intrauterine misoprostol was associated with less intraoperative blood loss (450 ± 50 mL vs. 500 ± 70 mL; p = 0.01) and lower decrease in hemoglobin (1.2 ± 0.4 g/dL vs. 1.6 ± 0.5 g/dL; p < 0.001). Complications were reported to be less in the intrauterine group than in the extra amniotic group (18% compared to 32%; p = 0.02).
Conclusion: Intrauterine misoprostol is more effective and safe than the per-rectal one for the prevention of PPH, especially during a cesarean section.
References
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Dr Sobia Hamza
Registrar Obstetrics & Gynecologist, MTI Khyber Teaching Hospital Peshawar, Pakistan
Dr Naseema Usman
District Gyenacologist, DHQ Battagram, Pakistan
Dr Sumaira Pervaiz
FCPS Gynaecologist, Gynae Department Unit 1, DHQ Sahiwal, Pakistan
Dr Fatima Bibi
Senior Registrar, Department of Obstetrics and Gynaecology, Ziauddin University Karachi, Pakistan
Dr Bisma Fatima Aslam
Assistant Professor, Department of Pharmacology & Therapeutics Azra Naheed Medical College, Lahore, Pakistan.
Dr KinzaMazhar
House Officer Obstetrics and Gynaecology, DHQ Hospital Sargodha, Pakistan