The following work studied how birth interval and antenatal care contribute to occurence of postpartum haemorrhage and how these factors modulates the preventive efficacies of oxytocin injection and misoprostol tablets in postpartum haemorrhage. A total of 1140 pregnant women who have received either oxytocin injection or oral misoprostol in third stage of labour as a prophylaxis of postpartum haemorrhage, were enrolled within three health care facilities in Maiduguri, Nigeria. Each patient was observed at parturition and for 24 h after during which blood lost was estimated to the nearest ml. Maternal characteristics were recorded in a structured proforma. The relationship of the occurrence of PPH (blood loss > 500 ml) and mean blood loss was studied with respect to the prophylactic medication used and some obstetric factors. The occurrence of PPH in subjects that had 'inadequate' resting period (29.3 %) was higher than that of the 'adequate' resting period group (2 %). Misoprostol exhibited greater PPH prevention in the "inadequate" resting period category (83.9 versus 38.8%). The enrolees that had inadequate antenatal care exhibited higher occurrence of PPH than the adequate group (21.6 versus 16.6%). In the misoprostol medication subgroup , there was significantly (p < 0.001) higher occurrence of PPH in the "adequate ANC" category (37.6%) than in the "inadequate ANC" category (7.1%). Inadequate birth interval and inadequate antenatal care are risk factors for PPH. The relative efficacies of oral misoprostol and parenteral oxytocin significantly vary with varying level of antenatal care and birth interval.

Aim: The following work studied how tribal affiliation, educational level and occupation of some women that had PPH in Maiduguri metropolis between September 2007 and March 2009 relate with PPH occurrence. The study was aimed at identifying possible risk factors and also to compare the relative prevention efficacies of oxytocin or misoprostol within the matrix of these factors. Method: A total of 1800 pregnant women who have received either oxytocin injection or oral misoprostol in third stage of labour as a prophylaxis of postpartum haemorrhage, were enrolled within three health care facilities in Maiduguri, Nigeria. Each patient was observed at parturition and for 24 h after, during which blood lost was estimated to the nearest millilitres. Demographic characteristics were recorded in a structured proforma. The relationship of the occurrence of PPH (occurrence of blood loss > 500 ml) and mean blood loss (MBL) was studied with respect to the prophylactic medication used and some demographic factors. Results: The incidence of PPH was higher in Igbo, and some "minority" tribes of Borno state (Babur, Bura, Mafa). The tribes that constituted the majority of the study population (Kanuri, and Hausa) exhibited low incidences of PPH. Significant relationships were demonstrated between PPH and educational levels and occupations of participants. Conclussions: It was concluded that PPH occurrence is related to tribal affiliation, educational level and occupation, and the relative efficacies of oxytocin and misoprostol varies between the tribal groups.

The following work compared adverse effects profile and patients' acceptability of intra-venous oxytocin 10 iu and oral misoprostol 600 ug used in the prevention of postpartum hemorrhage in the third stage of labour. A total of 1865 pregnant women who have received either oxytocin injection or oral misoprostol in third stage of labour as prophylaxis for postpartum haemorrhage, were enrolled within three health care facilities in Maiduguri, Nigeria. Each patient was observed at parturition and for 24 h after during which oral interviews were conducted and clinical notes studied. The oxytocin medication group exhibited higher abdominal pains (7.1% versus 0.0%; p < 0.001) and headache (1.9% versus 0.1%; p < 0.001), while the misoprostol group showed higher shivering (33.9% versus 0.0%; p < 0.001) and fever (19.7% versus 1.8%; p < 0.001). There were no significant differences in other side effects like nausea and vomiting. There was no statistically significant (p > 0.05) difference in patients acceptability of injectable oxytocin (99.3%) and oral misoprostol (98.3%). Oxytocin usage in the prevention of PPH was associated with abdominal pains and headache while misoprostol was associated with shivering and fever. Patients from this study have demonstrated high level of acceptability of both parenteral oxytocin and oral misopristol prevention of post-partum haemorrhage.