Prostaglandin F2 alpha: an effective alternate to surgical control of postpartum hemorrhage in uterine atony

ABSTRACT

To find out the use of Prostaglandin F2 alpha to avoid the surgical control of primary postpartum hemorrhage due to uterine atony and the adverse effects associated with prostaglandin F2 alpha. This was a Quasi-Experimental study carried out in obstetrics and gynecology unit 3 of Khyber Teaching Hospital Peshawar from 1st July 2003 - 30th June 2004. 50 patients having primary post partum hemorrhage due to uterine atony not responding to conventional oxytocics were given systemic and local prostaglandin F2 alpha. Vital signs, estimated blood loss and effect on uterine muscular tone were noted before and after prostaglandin F2 alpha. Surgical interventions were used in patients with continuous profuse vaginal bleeding despite maximum dose of prostaglandin F2 alpha and/ or hernodynamic instability of the patients. A semi-structured proforma was used to collect the data. A total of 44 [88%] patients responded well to the drug. Estimated blood loss before prostaglandin F2 alpha was 1000 - 4000ml with mean of 2250.00 + 686.98ml as compared to 416.00 + 294.41ml after prostaglandin F2 alpha was used. Side effects of the drug were mostly self limiting and required symptomatic treatment. No maternal death was recorded. Prostaglandin F2 alpha is an effective drug to control Primary post partum hemorrhage due to uterine atony and avoids surgical interventions in most of the patients. Side effects are minimum, most of which are self limiting