use of oral and rectal misoprostol in management of third stage of labor

To compare the effectiveness of oral and rectal misoprostol versus combined intramuscular oxytocin and ergometrine in the management of third stage of labor. Women with low risk for post-partum haemorrhage in the 3[rd] stage of labor were allocated to review either oral misoprostol [600 ug, n = 100], or rectal misoprostol [400 ug, n = 100], or intramuscular syntometrine [5/U oxytocin and 0.5mg eryometrine, n = 100]. Clinical and hematological parameters were compared. Oral and rectal misoprostal had similar outcome variables the duration of the 3rd stage of labor and rate of manual separation of the placenta were less in misoprostol users. They also had lower 3rd stage blood loss, needed less ecobolics and none of them needed blood transfusion compared to syntometrine user. Post-partum Hb and Hct levels were significantly lower in syntometrine group than misoprostol groups. Post-partum hypertension seen more with syntometrine, while in misoprostol women had more shivering. Oral and rectal misoprostol can be used safely in the management of the 3[rd] stage of labor

Diagnostic accuracy of sonohysterogrphy, transvaginal sonography and hysterosalpingography in evaluation of habitual abortions

To assess the diagnostic and accuracy of sonohysterography [SMG], hysterosalpingography [HSG] and transvaginal ultrasonography [TVU] in the detection of uterine cavity abnormalities in patients with recurrent pregnancy loss. Hysteroscopy was the gold standard. Subjects and methods: Forty five patients with recurrent pregnancy loss underwent TVU, SHG and HSG. The results of each examination were compared with those obtained by hysteroscopy. There was tolal agreement between hysteroscopy and SHG in detecting submucous myoma, uterine malformation and intrauterine adhesions while sensitivity rates of TVU for these lesions were 57.1%, 66.7%, and 0% respectively and 100% sensitivity rates. For intrauterine polyp detection SHG had higher sensitivity [75%] than TVU [25%] and both procedures had 10[3% specificity rates, I-ISO had 100% accuracy for detection of uterine malformation, low PPV [46.15%] for diagnosis of sub-mucous myoma and polyps and low PPV [66.7%], for intrauterine adhesion detection, SHG is a method of choice for the diagnosis of intrauterine pathology in habitual abortion patients