Anandhi, S (2020) A Comparative study between Misoprostol Combined with Oxytocin Versus Oxytocin Alone in reducing PPH. Masters thesis, Coimbatore Medical College, Coimbatore.
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Abstract
BACKGROUND: Postpartum Haemorrhage (PPH) is one of the major causes of maternal mortality globally. PPH is commonly defined as blood loss of 500ml or more within 24hours of normal vaginal delivery and loss of more than1000ml in caesarean delivery. The WHO recommends standard treatment of 10Units of intramuscular oxytocin in third stage of labour to prevent PPH. Although oxytocin is the gold standard drug in preventing PPH, it is heat sensitive and requires refrigeration to maintain its stability and potency. Misoprostol is a synthetic prostaglandin E1 analogue that can be used in management of PPH. Advantages of misoprostol is that it is heat stable, can be formulated as a tablet, has long half-life, of low cost, easily available and can be easily administered. Sublingual misoprostol gets absorbed faster. This study is done with the hypothesis that combined administration of both oxytocin and misoprostol will have synergistic and additive effects in reducing postpartum blood loss. AIM OF THE STUDY: The aim of this study is to compare the efficacy and safety of misoprostol combined with oxytocin versus oxytocin alone in reducing postpartum blood loss when given during Active Management of Third Stage of Labour (AMTSL). METHODOLOGY: After obtaining Institutional Ethical Committee approval, 160 term pregnant women in labour with normal antenatal history undergoing vaginal delivery were recruited and randomised into 2 groups of 80 each. Demographic details and complete history were recorded during enrolment.80 subjects in control group received 10 International Units (IU) of intramuscular oxytocin during third stage of labour and 80 subjects in study group received 600μg of sublingual misoprostol along with standard 10 IU of intramuscular oxytocin in third stage of labour. Efficacy was measured in terms of volume of blood loss during delivery, need for additional uterotonic agents and need for blood transfusion. Safety was assessed from complaints of patients, by clinical examination and by investigations. RESULTS: Mean blood loss in oxytocin group was 237ml compared to misoprostol with oxytocin group which was 187ml. Statistically significant difference was observed on comparison between groups in terms of blood loss. Adverse effects were more common with misoprostol added group, but they were self-limiting and transient. CONCLUSION: A single dose of 600μg of sublingual misoprostol as an adjunct to standard 10 units of intramuscular oxytocin will be more effective in reducing blood loss than using 10 units of intramuscular oxytocin alone during Active Management of Third Stage of Labour.
| Item Type: | Thesis (Masters) |
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| Additional Information: | 201716651 |
| Uncontrolled Keywords: | Postpartum Haemorrhage, Oxytocin, Misoprostol, Blood loss, pyrexia. |
| Subjects: | MEDICAL > Pharmacology |
| Depositing User: | Subramani R |
| Date Deposited: | 31 Jan 2021 12:37 |
| Last Modified: | 31 Jan 2021 12:37 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/13519 |
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