Evaluating the effectiveness of high-dose misoprostol in the prevention of postpartum haemorrhage

To investigate the effectiveness of high dose rectal msoprostolpreventing postpartum haemorrhage. Study design: 270 women were randomly allocated to receive 600 micro g misoprostol per rectum after norrnal vaginal delivery or to receive no medication in their third stage of labour. Any excessive bleeding in either group was actively managed with conventional oxytocic agents. Blood loss was measured directly. Setting: Damietta and Ali-Hussein University Hospitals. The inclusion criteria were similar. Blood loss of >/= 1000 ml occurred in 2.3% [3/1 30] of the misoprostol group and 6.4% [9/140] of the "no drug' group. Additional oxytocic therapy was required by 1.5% [2/130] and 4.2% [6/140] respectively. Side effects attributable to prostaglandins, particularly-shivering and pyrexia, occurred more frequently in the misoprostol group. The use of 600 micro g misoprostol per rectum in the management of the third stage of labour was well tolerated and associated with statistically significant less postpartum haemorrhage

Thermal endometrial ablation for the treatment of dysfunctional uterine bleeding a simplified method

In this study a Foley's catheter, inserted into the uterine cavity then its balloon filled with hot water at boiling temperature, was used to inflict thermal destruction of the endometrium in patients with perimenopausal DUB not responding to medical treatment. Twenty patients underwent this procedure performed under general anesthesia just after a formal D and C for endometrial sampling and removal of thick endometrium. These patients were followed up for 6 months postoperatively. None of these patients had any procedure related complications. 90% of patients had a favorable outcome while only 2 of them needed hysterectomy for treatment failure. The study showed that thermal endometrial ablation using hot water in a Foley's catheter balloon is a simple, inexpensive and effective method for treating most patients with perimenopausal DUB carrying a very minimal operative risk