Abstract
Misoprostol: an alternative to oxytocin in management of 3rd stage of labour in rural india??
Highlights
Postpartum haemorrhage has been a nightmare for obstetricians since centuries
The incidence of fatal PPH has been reduced in the Western world, largely because of active management of the third stage, which involves controlled cord traction, uterine fundal massage, and administrationof a pharmacologic uterotonic[4].The standard pharmacologic uterotonic agent has traditionally been oxytocin or a combination of oxytocin and ergometrine maleate (Syntometrine)
Most uterotonics must be administered by injection; which requires sterile equipment and training in safe administration, prerequisites which are unavailable for most women delivering in poor undeveloped countries.Misoprostol, a prostaglandin E1 analog can be administered orally, rectally, or sublingually.Misoprostol offers distinct advantages because it is stable at room temperature, affordable, and easy to administer
Summary
Postpartum haemorrhage has been a nightmare for obstetricians since centuries. One of the commonest causes of maternal mortality in the developing world is obstetric haemorrhage, postpartum hemorrhage[1,2,3]. The incidence of fatal PPH has been reduced in the Western world, largely because of active management of the third stage, which involves controlled cord traction, uterine fundal massage, and administrationof a pharmacologic uterotonic[4].The standard pharmacologic uterotonic agent has traditionally been oxytocin or a combination of oxytocin and ergometrine maleate (Syntometrine). Use of these agents routinely during the third stage of labour has demonstrated a 40% average decrease in PPH[4]. This supports the utility of misoprostol as a safe and effective uterotonic for use in the rural and remote areas of developing countries where other pharmacologic agents may be less feasible
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