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

ABSTRACT

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