A comparative study between misoprostol combined with oxytocin versus oxytocin alone in reducing post-partum blood loss

Abstract

Background: Oxytocin remains as the first line utero-tonic drug used in the management of postpartum hemorrhage (PPH). Because of its certain disadvantages, another cost effective uterotonic drug which can be used orally or vaginally with good absorption is misoprostol, which is a prostaglandin E1 analogue. The study aimed to compare and evaluate the effectiveness of oxytocin versus oxytocin plus misoprostol in the prevention of PPH. Materials and methods: A prospective randomized interventional study was conducted on 160 term pregnant women from February 2019 to August 2019. The study subjects were randomized into two groups of 80 each. During the active management of third stage of labour, all patients in the study group were administered with standard drug treatment of 10 IU of oxytocin through intramuscular route along with 600µg of misoprostol given sublingually, whereas the patients in the control group were given only 10IU of oxytocin alone. Results: The average postpartum blood loss and the need for blood transfusion were significantly higher among the control group compared to the study group. The overall incidence of PPH was found to be 28.5% among the control group and it was 6.4% among the study group. Adverse events such as fever, shivering, nausea, vomiting and diarrhoea were more among the study group than that of the control. Conclusion: A single dose of 600µg of sublingual misoprostol as an adjunct to standard 10 units of intramuscular oxytocin was found to be more effective in reducing blood loss than using 10 units of intramuscular oxytocin alone in the Active Management of Third Stage of Labour.