Aim – The aim of the study was to study the effect of sublingual misoprostol for prevention of PPH.
Materials and Methods – This was a prospective, randomized, double blind, placebo controlled study. Inclusion criteria were women aged 20-40
years with 38-40 weeks of gestation who underwent elective caesarean section. Exclusion criteria were women have risk factors for post-partum
haemorrhage, active thromboembolic disease and intrinsic risk for thrombosis. Participants were randomly assigned to misoprostol group or group
A (n=50) and placebo group or group B(n=50). Group A received 400µg of sublingual misoprostol after delivery of the baby, group B received
placebo tablet at the same time. Primary outcome measures were blood loss from delivery of the placenta to the end of the caesarean section to 2
hours postpartum, haemoglobin estimation was done in all patients pre operatively and 24 hours post operatively and the change in concentration
was noted. Secondary outcome measures were need for additional uterotonics, use of additional surgical interventions to control post-partum
haemorrhage.
Result – Blood loss from both placental delivery to the end of caesarean section and from end of caesarean section to 2 hours postpartum were
signicantly lower in the study group. (p<0.0001). Change ifn haemoglobin concentration in study group was also signicantly less than in the
control group. (p<0.0001). Total amount of Oxytocin required was signicantly less in the study group (p=0.01). The number of women requiring
other oxytocics (inj. Methyl ergometrine, inj. Carboprost) was signicantly less in study group (p=0.0078).
Conclusion – Sublingual misoprostol has been found to be effective in preventing PPH.
Tranexamic acid for post-partum haemorrhage: What, who and when