Randomized controlled trial on prevention of postpartum haemorrhage with sublingual misoprostol or oxytocin

ABSTRACT

Failure of the uterus to contract adequately after child birth [a tonicity] is the most common cause of postpartum hemorrhage and misoprostol produces a rapid peak concentration, and is more effective than oral administration. We compared the postpartum blood loss with 400microg sublingual misoprostol and after standard care using 10 iu intramuscular oxytocin. Randomized controlled trial. This study was conducted in a Department of Obstetrics and Gynecology Ghulam Muhammad Mahar Medical College Teaching Hospital Khairpur Sindh during 2011. 60 women for each group were assigned to receive the study medications with in 1 minute of clamping and cutting the cord. Chi-square and studentt-test were used to test categorical and continuous outcomes. Mean postpartum blood loss and PPH [>500ml], >10% pre- to postpartum decline in hemoglobin and reported side effects. The mean estimated blood loss with sublingual misoprostol was 200 +/- 125ml [n=60] and 360 +/- 136ml with oxytocin [n=60] P-value incidence of PPH was 3.3% with misoprostol and 6.6% with oxytocin group. No women lost >1000 ml of blood. Hemoglobin decline of > 10% observed that 11.6% and 45.0% in women after receiving misoprostol and oxytocin [Pmisoprostol group than in the oxytocin group. In this trial we found sublingual misoprostol more effective than intramuscular oxytocinin reducing PPH, with only transient side effects