Management of third stage of labor with misoprostol: A comparison of three routes of administration

Bajwa, Sukhwinder Kaur; Bajwa, Sukhminder Jit Singh; Kaur, Harpreet; Goraya, Sps; Singh, Anita; KaurIshar, Harpreet

doi:10.4103/2229-3485.100666

Cited by 11 publications

(17 citation statements)

References 17 publications

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“…The incidence in oral group is 32%, this is correlating with Bajwa et al =36%. 15 In sublingual group it is 30%, correlating well with Hoj et al-31%. 13 In rectal group, side effects are minimum of 14%, correlating with Bajwa et al-12%.…”

supporting

confidence: 74%

“…13 The mean blood loss in present study was 353 ml, it was minimal in sublingual group (305 ml) which is correlating with Bajwa et al 210 ml, Hoj et al, 443ml. 13,15 In oral route it was 356ml which is correlating with Bajwa et al 206ml, in rectal route 398 ml which is correlating with Bajwa 15 et al 236 ml and Neeta et al 230ml. 12,15 The blood loss in sublingual route is significantly less than other routes.…”

mentioning

confidence: 71%

“…13 In rectal group, side effects are minimum of 14%, correlating with Bajwa et al-12%. 15 All the three routes were safe and effective in preventing PPH from the present study. Sublingual route is the best route for administration of misoprostol for the active stage of labour.…”

mentioning

confidence: 81%

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A comparative study of different route of administration of misoprostol in the management of third stage of labour

Sreelatha

Nethra

Nadagoudar

et al. 2017

Int J Reprod Contracept Obstet Gynecol

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INTRODUCTIONThird stage of labour begins after the delivery of the fetus till the expulsion of the placenta and membranes. 1 Though the third stage constitutes short span of time, it is the phase of maximum maternal mortality and morbidity.One of the major hazards being post partum haemorrhage. PPH complicates approximately 4% of vaginal deliveries and 6% of caesarean deliveries. WHO statistics suggest 30% of maternal deaths worldwide with an estimated 1.25 million cases and morbidity in 20 million women annually are due to PPH. 2,3Uterine atony is the most common cause constituting about 80-90% of cases.4 So, we have to aim at increasing the tone of the uterus by using uterotonic drugs to reduce PPH. Various uterotonic drugs is available like Oxytocin, Ergometrine, Prostaglandins.5 To prevent and treat PPH, literature strongly suggests the use of active management of 3rd stage 6 which includes use of Oxytocin at the time of delivery of anterior shoulder, controlled cord traction, ABSTRACT Background: Post partum haemorrhage is the most common cause of maternal morbidity and mortality. Misoprostol is a prostaglandin analogue, used for management of post partum haemorrhage. It can be used by various routes with minimal side effects. This study is done to compare the different routes of administration of Misoprostol for the third stage management and their side effects. Objectives of present study were to estimate the amount of blood loss, to assess the maternal side effects of drug, to know the haemoglobin deficit, to know the duration of third stage of labour. Methods: This was a prospective hospital base study of 150 women delivery at obstetrics and gynaecology department at ESICMC Model Hospital, Rajajinagar. They were randomized into 3 groups of 50 patients each. They received 400 µg of misoprostol either orally or rectally or sublingually immediately after delivery of the fetus. The primary outcomes analysed were amount of blood loss duration of third stage of labour haemoglobin deficit and their side effects Results: The amount of blood loss and haemoglobin deficit was least in sublingual group which was statistically significant. Need of additional oxytocics was less in sublingual and oral group, though it was not statistically significant. Conclusions: In the present study, sublingual Misoprostol was found to be more effective in reducing blood loss during third stage of labour.

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confidence: 71%

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A comparative study of different route of administration of misoprostol in the management of third stage of labour

Sreelatha

Nethra

Nadagoudar

et al. 2017

Int J Reprod Contracept Obstet Gynecol

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“…Several other studies 8,20 have also observed that peripartum fall in hematocrit level by at least 10% from before delivery to 24 hours after delivery, is a better definition than the volume criteria of PPH. In this study the efficacy of the two regimes in the active management of the third stage of labour was mainly based on assessment of the degree of fall in hematocrit following delivery in the two groups.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Oral Misoprostol with Intramuscular Oxytocin in the Active Management of Third Stage of Labour

Kaudel

Rana

Ojha

2015

Nepal j. obstet. gynaecol.

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Aims:This study aimed at comparing the efficacy of oral misoprostol 600 mcg with intramuscular oxytocin 10 IU in the active management of third stage of labour.Methods: This prospective comparative study was performed in Tribhuvan University Teaching Hospital to compare the efficacy of oral misoprostol with intramuscular oxytocin in the third stage of labour for the prevention of postpartum hemorrhage. One hundred and twenty women without risk of PPH were randomly allocated to receive either 600 mcg misoprostol orally (Group A) or 10 unit of oxytocin intramuscularly (Group B) within 1 minute of delivery. The efficacy and the safety of these two drugs were analyzed on the basis of percentages fall in hemoglobin (Hb) and hematocrit (Hct) level from before delivery to 8 completed hours after delivery, need for additional uterotonic agents, need for exploration and uterine evacuation, need for blood transfusion, duration of third stage of labour and the numbers of retained placenta and need for MRP. Results:Oral misoprostol was observed to be equally effective as intramuscular oxytocin in prevention of post-partum hemorrhage (PPH). There was no statistical difference in the duration of third stage of labour, need for additional uterotonics, need for uterine exploration/evacuation and need for blood transfusion in the two groups.Conclusions: Routine use of oral misoprostol 600 mcg appears to be as effective as 10 IU intramuscular oxytocin in minimizing blood loss during the third stage of labour.Keywords: active management of third stage of labour; misoprostol; oxytocin.

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“…[4][5][6][7][8][9][10] Several other studies, Bugalho et al and Bajwah et al have also shwon that peripartum decrease in haematocrit level by at least 10% from pre-delivery to 24 hours postdelivery, is a better definition than the volume criteria of PPH. 17,18 In these studies, the effectiveness of the two regimes in the active management of the third stage of labour was primarily based on measurement of the degree of fall in haematocrit following delivery in the two study groups.…”

Section: Discussionmentioning

confidence: 99%

Oral Misoprostol Versus Intramuscular Oxytocin in Active Management of Third Stage of Labour: A Comparative Study

Naskar¹,

Dasgupta²,

Das³

2019

jebmh

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BACKGROUNDPostpartum haemorrhage continues to be leading cause of maternal death worldwide. In low resource set up, where there is non-availability of oxytocin, oral misoprostol effectively reduces the haemorrhage in third stage of labour.The aim of this study was to compare the effectiveness of oral misoprostol 600 mcg with intramuscular oxytocin 10 IU in the active management of third stage of labour. MATERIALS AND METHODSThis was a prospective study performed at R. G. Kar Medical College and Hospital to compare the efficacy of oral misoprostol with intramuscular oxytocin in the active management of third stage of labour. In group A, 27(50%) women without risk of PPH were randomly allocated to receive 600 mcg misoprostol orally and in group B also 27(50%) women included by random allocation among total 54 total samples to receive 10 units of oxytocin intramuscularly within 1 minute of delivery. The efficacy and the safety of these two drugs were assessed on the basis of, percentages reduced in haemoglobin (Hb) and haematocrit (Hct) level in pre-delivery and 24 hours post-delivery, requirement of extra uterotonic agents, need for exploration and evacuation of uterus, blood transfusion requirement and duration of third stage of labour. RESULTSIt was observed that oral misoprostol was as effective as intramuscular oxytocin in prevention of post-partum haemorrhage (PPH). There was no statistically significant difference in the duration of third stage of labour, requirement of extra uterotonics (misoprostol group 11.1% vs. 7.4% oxytocin group), and blood transfusion requirements in the two study groups. CONCLUSIONOral misoprostol 600 mcg appears to be as effective as intramuscular oxytocin 10 IU in reducing blood loss during the third stage of labour.

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Management of third stage of labor with misoprostol: A comparison of three routes of administration

Cited by 11 publications

References 17 publications

A comparative study of different route of administration of misoprostol in the management of third stage of labour

A comparative study of different route of administration of misoprostol in the management of third stage of labour

Comparison of Oral Misoprostol with Intramuscular Oxytocin in the Active Management of Third Stage of Labour

Oral Misoprostol Versus Intramuscular Oxytocin in Active Management of Third Stage of Labour: A Comparative Study

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