A comparative study of oxytocin, carboprost, methylergometrine and misoprostol in prevention of postpartum haemorrhage a prospective study

Abstract

Background: Post partumhemorrhage (PPH) is an important cause of maternal mortality accounting for nearly 15-20% of maternal deaths in India. Oxytocic drugs like oxytocin, ergot alkaloids, and various prostaglandins are being used for active management of third stage of labour. Materials and Methods: A prospective study was conducted in the Department of Obstetrics and Gynaecology of Al Ameen Medical College, Vijayapur, in 400 women. Patients were randomized into four groups of 100 each and were given oxytocic within 60 seconds of delivery anterior shoulder of the baby. Oxytocics used were 10 IU intramuscular oxytocin,125 µg intramuscular carboprost, 0.2 mg intravenous methylergometrine, and 800 µg tablet misoprostol per rectally in groups A, B, C and D respectively. Results: Duration of third stage of labor recorded was minimum with carboprost with mean duration of 3.84+/-0.99 minutes and was maximum with methylergometrine with mean duration of 5.04+/-1.02 minutes. Amount of blood loss observed was minimum with carboprost (mean 131 +/-72.037 ml) and maximum with Methylergometrine (mean 435+/-147.578 ml). Hemoglobin drop was also seen more with Methylergometrine with mean drop of 0.872+/-0.458 gm% and minimally with carboprost with mean drop of 0.236 +/-0.221 gm%. Conclusion: It is concluded from this study that carboprost is the uterotonic of choice followed by oxytocin for active management of third stage of labor.