scholarly journals Randomized controlled trial of rectal misoprostal and intramuscular oxytocin in the prevention of PPH

2017 ◽  
Vol 6 (5) ◽  
pp. 1101 ◽  
Author(s):  
Savitha A. ◽  
Sarita H. ◽  
Kashinath Gumma
Keyword(s):  
Blood Loss ◽  
Controlled Trial ◽  
Randomized Study ◽  
P Value ◽  
Singleton Pregnancy ◽  
Risk Pregnancy ◽  
Third Stage Of Labor ◽  
Third Stage ◽  
Misoprostol Group ◽  
Uterotonic Agent

Background: PPH accounts for merely 23% of maternal mortality in developing countries.  Misoprostol is a uterotonic agent and is a PGE analogue commonly used in management of PPH. Oxytocin is another uterotonic agent which is now been introduced as intramuscularly effective agent to prevent PPH.This study aims to compare rectal misoprostol with intramuscular oxytocin in reducing blood loss in third stage of labor to prevent PPH. Objective of present study is to compare the clinical effect of rectal misoprostol with intramuscular oxytocin in prevention of PPH.Methods: A randomized study was conducted over duration of 3 months, at Department of OBG, BRIMS, Bidar, Karnataka, India. Patients with singleton pregnancy with the history of one previous LSCS and opting for elective LSCS were included in the study. Patients with risk pregnancy, such as pre eclampsia, cardiac disease and asthma or grand multipara were excluded from the study. Immediately after spinal anesthesia rectal misoprostol was given while oxytocin was administered after delivery of the baby. Incidence of PPH and amount of blood loss was observed and compared.Results: The difference in both the groups with regard to mean amount of blood loss, mean duration of the third stage of labor, and mean amount of fall in hemoglobin level was not statistically significant as P value was >0.05. The incidence of PPH and the need for additional oxytocic are slightly more in the misoprostol group. The incidence of shivering and pyrexia was more in the misoprostol group, but not so disturbing so as to lead to disuse of this drug.Conclusions: Oral misoprostol, though not a replacement of parenterally administered oxytocin, can be used safely in all deliveries for the prevention of postpartum hemorrhage.

scholarly journals Comparison between oxytocin, ergometrine and misoprostol in active management of the third stage of labour: a randomized controlled trial

2018 ◽  
Vol 7 (6) ◽  
pp. 2076
Author(s):  
Abubaker Y. H. Abdel Rahim ◽  
Mohamed A. A. Gadir E. Ounsa ◽  
Rayan G. Albarakati ◽  
Elsadig Y. Mohamed ◽  
Sawsan M. Abdalla
Keyword(s):  
Blood Loss ◽  
Intravenous Infusion ◽  
Controlled Trial ◽  
University Hospital ◽  
Active Management ◽  
Singleton Pregnancy ◽  
The Third ◽  
Third Stage Of Labor ◽  
Third Stage ◽  
Sublingual Misoprostol

Background: The aim of the present study was to compare the effectiveness of sublingual misoprostol, intravenous infusion of oxytocin, and intravenous infusion of Ergometrine in reducing blood loss during the third stage of labor.Methods: This is a no-random trial study conducted in in Ribat University Hospital, Khartoum among 150 laboring ladies with a healthy singleton pregnancy. After obtaining their written informed consent to participate in the study, they were randomly assigned to one of three possible treatment groups: 400 μg of sublingual misoprostol; 10 IU of intravenous infusion oxytocin; and 0.5 mg of intravenous infusion of Ergometrine. Blood loss was estimated by weighing the collected blood and converting the weight to milliliters.Results: The shortest mean duration of the third stage of labor was seen in patients who received misoprostol (3.89±0.37 min), followed by oxytocin (4.6±0.9 min), and Ergometrine (5.45±0.9 min). The lowest mean blood loss was seen in the patients who received 400 µg misoprostol (168.36±24.83 ml), followed by those who received 10 IU oxytocin (205.56±34.82 ml), and 0.5 mg Ergometrine (214.49±35.97 ml).Conclusions: Present study showed that 400 µg sublingual misoprostol was more effective than the conventional parenteral uterotonics in reducing the amount of the blood loss during the third stage of labor and has comparable effect to that of 10 IU intravenous oxytocin in shortening the duration of third stage of labor. It also showed that the use of misoprostol reduces the need for extra-uterotonics and blood transfusion.

Effect of Different Doses of Intraumbilical Oxytocin on Third Stage of Labor

2016 ◽  
Vol 8 (4) ◽  
pp. 286-289
Author(s):  
Devyani Sawai ◽  
Susheel Kumar Sharma ◽  
Geeta Jain
Keyword(s):  
Blood Loss ◽  
Randomized Study ◽  
Multiple Pregnancy ◽  
Medical College ◽  
Medical Disorders ◽  
Third Stage Of Labor ◽  
Third Stage ◽  
Before And After ◽  
Different Doses ◽  
Singleton Pregnancies

ABSTRACT Objectives A prospective randomized study was conducted from May 2012 to April 2014 at the Department of Obstetrics and Gynecology, Dr. Sushila Tiwari, Memorial Government Hospital and Government Medical College, Haldwani. Its aim was to study and compare the effects of different doses of intraumbilical oxytocin on 3rd stage of labor with respect to duration and amount of blood loss. Materials and methods The study comprised 200 antenatal cases and included patients with singleton pregnancies at term and spontaneous onset of labor while excluding those with medical disorders of pregnancy, antepartum hemorrhage (APH), multiple pregnancy, polyhydramnios, chorioamnionitis, severe anemia, Rh negative pregnancy, pregnancy-induced hypertension (PIH), prior cesarean delivery, and forceps or ventouse application during delivery. History and examination was taken in each patient before delivery and hemoglobin and hematocrit were noted before and after delivery. Progress of labor was monitored and each patient was randomized into one of the four groups according to the dose of oxytocin to be given. Results Increasing doses of oxytocin resulted in decrease in duration of 3rd stage of labor and amount of blood loss. Conclusion Third stage of labor and amount of blood loss significantly reduced by increasing the dose of oxytocin to 30 IU. How to cite this article Sawai D, Sharma SK, Jain G. Effect of Different Doses of Intraumbilical Oxytocin on Third Stage of Labor. J South Asian Feder Obst Gynae 2016;8(4):286-289.

scholarly journals A Comparative Study of Active Management of the Third Stage of Labor IV Methergine and IM Oxytocin

2021 ◽  
pp. 267-272
Author(s):  
K. Sharmila
Keyword(s):  
Blood Loss ◽  
The United States ◽  
Active Management ◽  
P Value ◽  
Negative Effects ◽  
The Third ◽  
Third Stage Of Labor ◽  
Group I ◽  
Third Stage ◽  
The Mean

Postpartum haemorrhage (PPH) has been more common over the last three decades, accounting for 11% of all pregnancy-related deaths in the United States. In the third stage of labour, risk classification and active management are crucial preventative techniques. To avoid negative effects, a multidisciplinary approach to PPH patient care is required. To treat uterine atony, uterotonic medicines like oxytocin are used in combination with manipulative procedures like uterine massage and balloon tamponade. The amount of blood loss, duration of the third stage, need for MRP, incidence of PPH, need for repeated oxytocics, and its side effects were measured in Group I 100 women who were administered injection oxytocin 10 IU injection methergin 0.2 mg IV within one minute of the baby's delivery. The mean blood loss at vaginal delivery in Group I was 100-150 ml and in group I P value 0.027, which was statistically significant .In  Group II was 160-200 ml with P value 0.036, which was statistically significant. The mean duration of third stag labour in Group 1 was 124.6 min and Group 2 was 144.8 min intravenous methergin is a better uterotonic when compared to intramuscular oxytocin to reduce the amount of blood loss at delivery and prevent complications like atonic PPH.

scholarly journals COMPARISON OF MISOPROSTOL WITH OXYTOCIN IN THIRD STAGE OF LABOUR

2018 ◽  
Vol 6 (1) ◽  
pp. 19-21
Author(s):  
Nilam Subedi ◽  
Deepanjali Sharma ◽  
Rubby Das
Keyword(s):  
Blood Loss ◽  
Active Management ◽  
Secondary Outcome ◽  
Secondary Outcome Measure ◽  
Medical Sciences ◽  
Third Stage Of Labor ◽  
Third Stage ◽  
Misoprostol Group ◽  
Group 2 ◽  
To Receive

Introduction: Postpartum Haemorrhage (PPH) is one of the leading causes of maternal mortality worldwide. A simple measure to prevent PPH is active management of third stage of labour (AMTSL). This prospective study was conducted in Universal College of Medical Sciences and Teaching Hospital, Tribhuvan University,  Bhairahawa where misoprostol  600  mcg  orally was compared with the standard  oxytocin regime in active management of third stage of labour.Materials and Methods: A total of 100 women were selected to receive either 600 mcg misoprostol orally or 10 IU oxytocin intramuscularly. The incidences of postpartum hemorrhage and side effects were examined.Results: Both groups were comparable in age, parity, gestational age, pre-delivery hemoglobin, and duration of labor. There was no significant differences between the misoprostol and oxytocin groups in terms of blood loss  96% vs 100% had blood loss of < 500 ml, p=0.475). And incidence of PPH  (4% vs 0%). None of the group had severe PPH i.e. blood loss> 1000 ml. The duration of the third stage of labor, a secondary outcome measure was shorter in the misoprostol group than in the oxytocin group (7.02±2.26 SD vs 8.44±4.08 SD, p=0.034). Two women of oxytocin group received a blood transfusion. The adverse effects of shivering and pyrexia were encountered more frequently in the misoprostol than in the oxytocin group (2% vs 38%, p<0.001, P<0.001; and 2% vs 10%, p=0.207). No major surgical intervention for atonic PPH was needed and no maternal deaths occurred in either group.Conclusion: Misoprostol 600 mcg orally is equally as effective as standard oxytocin regime in AMTSL to prevent PPH and can be safely used in the peripheral institutions or by midwives where there is lack of trained personnel and storage facility.Journal of Universal College of Medical SciencesVol. 6, No. 1, 2018, Page: 19-21

scholarly journals Study of effect of intra-umbilical oxytocin along with active management in third stage of labor

2021 ◽  
Vol 10 (9) ◽  
pp. 3486
Author(s):  
Neetu Verma ◽  
Monica Soni ◽  
Priyanka Singh
Keyword(s):  
Blood Loss ◽  
Normal Saline ◽  
Demographic Data ◽  
Active Management ◽  
P Value ◽  
Study Group ◽  
Third Stage Of Labor ◽  
Third Stage ◽  
Group A ◽  
Group B

Background: The aim of the study was to determine effect of intra-umbilical oxytocin along with active management on duration and amount of blood loss in 3rd of stage of labor.Methods: This was a hospital based prospective, randomized, case-control study conducted in the department of OBG between 1st September 2019 to 31st December 2020. After obtaining permission from ethical committee, screening of inclusion and exclusion criteria and informed consent of participants, 300 cases were enrolled. In group A (control) 20 ml normal saline and in group B (case) 20 IU oxytocin diluted in normal saline to make a 20 ml solution was given intra-umbilically along with standard active management of third stage labor. The data was systematically recorded and analysed.Results: Both the groups were comparable in terms of demographic data.  A statistically significant reduction in the duration of third stage of  labor (1.83±0.64  min in group B vs 2.92±0.79 min in group A), amount of blood loss (203.73±62.11 ml in group B vs 328.83±87.18 ml  group A) and fall in haemoglobin (9.28±1.03 g/dl in the study group A vs 9.97±1.28 g/dl in group B) and haematocrit (31.20±3.05% in  study group A vs 33.60±3.31%  in study group B)  were noted, taking p value  significant <0.05.Conclusions: Intra-umbilical oxytocin was associated with a significant reduction in duration and amount blood loss in third stage of labor.

scholarly journals A Randomized Controlled Trial of Misoprostol and Oxytocin in the Management of Third Stage of Labor

1970 ◽  
pp. 14-16
Author(s):  
Rokshana Ivy ◽  
Hasmot Ara ◽  
Kulsum Haq ◽  
Farid Uddin Ahmed
Keyword(s):  
Developing Countries ◽  
Randomized Controlled Trial ◽  
Postpartum Hemorrhage ◽  
Postpartum Haemorrhage ◽  
Controlled Trial ◽  
Randomized Controlled ◽  
Third Stage Of Labor ◽  
Oral Misoprostol ◽  
Third Stage ◽  
Misoprostol Group

The study was conducted to compare the effectiveness and safety of oral misoprostol with intramuscular oxytocin in the management of third stage of labor. One hundred patients were selected randomly who are expected to have vaginal delivery. Fifty patients received oral misoprostol 600 microgram and other fifty patients received oxytocin 10 IU intramuscularly after the birth of the baby. There were no significant differences between the prevalence of postpartum hemorrhage, duration of third stage of labor, additional oxytocin requirement, manual removal of placenta and blood transfusion. About the side-effects, shivering and fever were significantly higher in misoprostol group (p<0.001) and (p<0.003) respectively. But there were no significant differences in other sideeffects. Oral misoprostol can be used instead of intramuscular oxytocin in the management of third stage of labor, to prevent postpartum hemorrhage, in developing countries, especially as it is administered orally and thermo stable in tropical climate. Key words: Misoprostol; Oxytocin; Postpartum haemorrhage DOI: 10.3329/bjpp.v24i1.5732Bangladesh J Physiol Pharmacol 2008; 24(1&2) : 14-16

Oral Misoprostol: A Safe and Effective Alternative in Comparison to Conventional Uterotonic Agents in the Active Management of Third Stage of Labor

2009 ◽  
Vol 1 (3) ◽  
pp. 19-23
Author(s):  
Mahmud Ghazala ◽  
Tasnim Nasira ◽  
Fatima Saba
Keyword(s):  
Blood Loss ◽  
Active Management ◽  
Efficacy And Safety ◽  
Safe Alternative ◽  
Third Stage Of Labor ◽  
Oral Misoprostol ◽  
Estimated Blood Loss ◽  
Third Stage ◽  
Misoprostol Group ◽  
To Receive

ABSTRACT Objective To determine the efficacy and safety of oral misoprostol with intravenous oxytocin and syntometrine in the active management of third stage of labor. Methodology 325 women were randomly allocated by convenient sampling to receive either 10 IU of intravenous oxytocin or 10 IU of oxytocin with 0.2 mg of Methergine (syntometrine) or 400 mcg of oral misoprostol at the delivery of anterior shoulder. Main outcome measures were estimation of blood loss > 500 ml, drop in hemoglobin/hematocrit levels and adverse effects of drugs. Results Estimated blood loss was significantly higher in group misoprostol group (p = 0.016) but comparable to oxytocin group (p = 0.40). Drop in hemoglobin level was comparable in all the three groups (p = 0.106). Drop in hematocrit value was significant for misoprostol and syntometrine (p = 0.022) but comparable to oxytocin. Nausea and vomiting was common in oxytocin and syntometrine group whereas fever and shivering was the leading adverse effect in misoprostol group. Conclusion Misoprostol is an effective and safe alternative to intravenous uterotonic agents in the active management of third stage of labor both at tertiary and community level.

scholarly journals A comparative study between intramuscular oxytocin and intramuscular methyl ergometrine in the active management of third stage of labour

2018 ◽  
Vol 7 (5) ◽  
pp. 1943 ◽  
Author(s):  
Devi Reddy Hema Swapnika ◽  
Prema Priya G. ◽  
S. Senthil Priya ◽  
A. S. Allirathinam
Keyword(s):  
Side Effects ◽  
Blood Transfusion ◽  
Blood Loss ◽  
Active Management ◽  
P Value ◽  
Singleton Pregnancy ◽  
The Third ◽  
Third Stage ◽  
The Difference ◽  
Vertex Presentation

Background: To compare the efficacy of prophylactic IM oxytocin 10U and IM methyl ergometrine 0.2mg on duration of third stage of labour, amount of blood loss during the third stage of labour and associated side effects.Methods: 50 low risk antenatal women with singleton pregnancy at term gestation in vertex presentation admitted for vaginal delivery, were randomly allocated into 2groups of 25 each and managed actively in the third stage of labour either with 10 U oxytocin IM or with 0.2mg methyl ergometrine IM immediately after the birth of the baby. The main outcome measures were the difference between the 2groups with regard to: duration of third stage of labour, blood loss by volume, difference in haemoglobin and haematocrit, need for blood transfusion, additional uterotonics and side effects of drugs.Results: The mean duration of third stage of labour in the oxytocin group was 6.68±2.17min and in methergine group was 6.4±1.93 min. Mean blood loss was 302±75.6ml and 282.8±58.27ml. Mean fall in Hb was 0.92gm% and 0.812gm%. Mean fall in PCV was 2.36% and 1.88%. 2women in oxytocin group and 1woman in methergine group received additional 0.2mg methergine. 3women in both groups received 1unit of blood transfusion. 8women who received methergine had side effects while only one in the oxytocin group, with a p value 0.004 which is statistically significant.Conclusions: This study has shown that both oxytocin and methylergometrine were equally efficacious. However, oxytocin had significantly better safety profile and lesser contraindications for usage.

scholarly journals Comparison of Misoprostol With Tranexamic Acid in Preventing Post-Partum Hemorrhage

2021 ◽  
Vol 15 (5) ◽  
pp. 914-916
Author(s):  
Maryam Matloob ◽  
Zille Hyder Syed ◽  
Rubina Qasim ◽  
Wafa Najeeb
Keyword(s):  
Blood Loss ◽  
Vaginal Delivery ◽  
Post Partum ◽  
Controlled Trial ◽  
Normal Vaginal Delivery ◽  
Third Stage ◽  
Misoprostol Group ◽  
Group A ◽  
The Mean ◽  
Group B

Aim: To compare the amount of average blood loss in transamine and misoprostol groups in patients undergoing spontaneous vaginal delivery in third stage of labour. Method: We conducted the randomized controlled trial from July 26th 2016 to 25th of January 2017. Results: In my study the mean age of the patients undergoing normal vaginal delivery was 28.47 years, parity wise, 31%, 33%, 24% and 11% of participants were para 1, para 2, para 3 and para 4 respectively. Mean blood loss in group A was 224.08 +/- 20.81mls and in group B 331 +/- 398 mls. Conclusion: This study has demonstrated that the blood loss in transamine group (group A) is less than the mean blood loss in misoprostol group (group B). Keywords: Transamine, misoprostol, normal vaginal delivery

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