scholarly journals Comparing the Effectiveness of Transrectal Misoprostol with Intravenous Oxytocin in Active Management of Third Stage of Labour in Preventing Post-partum Hemorrhage

2021 ◽  
pp. 272-278
Author(s):  
Nidhi Patel ◽  
Kiran Borkar
Keyword(s):  
Blood Loss ◽  
Post Partum ◽  
Vital Signs ◽  
Active Management ◽  
Intravenous Route ◽  
Post Partum Hemorrhage ◽  
Cardiovascular Side Effects ◽  
Significant Difference ◽  
Third Stage ◽  
Before And After

Background: PPH which is 500 ml or more blood loss in 24 hours of birth . Uterine atony has been the commonest cause of PPH. To prevent PPH uterotonics like oxytocin and misoprostol should be given. Intravenous route of oxytocin has rapid effect, but is associated with cardiovascular side effects like rise in heart rate and decrease in blood pressure. Slower rate of absorption, lower peak levels and reduced adverse effects is seen with misoprostol given rectally when compared to sublingual and oral routes. This study aims to compare the effectiveness of transrectal misoprostol and intravenous oxytocin in preventing post-partum haemorrhage. Objectives: To compare the effectiveness of 600mcg transrectal misoprostol with 10IU intravenous oxytocin in active management of third stage of labour in preventing PPH and recommend technique for active management of third stage of labour in preventing PPH. Methodology: Women randomized into two groups for prevention of PPH and are given 600ug of misoprostol per rectally and 10IU oxytocin intravenously. Duration of third stage, the blood volume in kidney tray and additional blood loss in sterile surgical pads for 24hrs will be noted. The blood loss due to episiotomy will be taken as 50ml.Need of additional uterotonics(oxytocin or misoprostol), blood transfusion, removal of placenta manually, haemoglobin before and after delivery will be noted. Monitoring of patients for vital signs, uterine tone, fundal height and vaginal bleeding for 2 hour will be done. Result: The expected outcome of the study will be a significant difference in the blood loss during third stage of labour and 24 hours in post-partum period when uterotonics like oxytocin or misoprostol are used in managing third stage of labour actively. Conclusion: Our study will show the effect of intravenous oxytocin and transrectal misoprostol in managing third stage of labour actively to prevent post-partum hemorrhage.

scholarly journals Intramuscular oxytocin 10 units versus intravenous methylergometrine 0.2 mg in active management of third stage of labour for prevention of postpartum haemorrhage: a comparative study

2020 ◽  
Vol 9 (2) ◽  
pp. 494
Author(s):  
Divya Narayana ◽  
B. Pathak ◽  
Abha Khurana ◽  
Uttara Aiyer Kohli
Keyword(s):  
Side Effects ◽  
Blood Transfusion ◽  
Blood Loss ◽  
Post Partum ◽  
Tertiary Care ◽  
Active Management ◽  
Normal Delivery ◽  
Post Partum Hemorrhage ◽  
The Third ◽  
Third Stage

Background: To compare the effectiveness of 10 IU of oxytocin IM with 0.2 mg methyl ergometrine IV in the prevention of post-partum hemorrhage when used as a part of active management of third stage of labour. This study aims to compare their influence on duration of the third stage of labour, the amount of blood loss during the third stage of labour and the immediate post-partum period and side effects of the drugs if any.Methods: The study was conducted in a tertiary care teaching hospital. 200 women, who underwent normal delivery with or without episiotomy, were enrolled and were randomly distributed into two groups. 100 women received 10 IU of intramuscular Oxytocin and 100 women received intravenous 0.2 mg of methyl ergometrine. Women of both the groups were given the medication after delivery of anterior shoulder of the baby. Comparison done between percentages fall in Hb from before delivery to 24 hours after delivery, need for additional uterotonic agents, need for blood transfusion, duration of third stage of labour and any side effects including retained placenta and need for manual removal of placenta.Results: Intravenous methylergometrine was observed to be equally effective as intramuscular oxytocin in prevention of post-partum hemorrhage. There was no difference in the duration of third stage of labour, amount of blood loss, need for additional uterotonic agents, and need for blood transfusion in both the groups. There was no significant side effect in both the groups.Conclusions: Intramuscular oxytocin is as efficacious as Intravenous methylergometrine in the prevention of postpartum hemorrhage with no side effects.

scholarly journals Active management of third stage of labor

1970 ◽  
Vol 1 (2) ◽  
pp. 25-27
Author(s):  
Meena Thapa ◽  
Rachana Saha ◽  
Sumita Pradhan ◽  
Sushil Thakur ◽  
Archan Shamsher Rana
Keyword(s):  
Blood Loss ◽  
Post Partum ◽  
College Teaching ◽  
Uterine Atony ◽  
Active Management ◽  
Retained Placenta ◽  
Average Blood Loss ◽  
Cord Clamping ◽  
Third Stage Of Labor ◽  
Third Stage

Objective: Overall objective of the study was to see effects of active management of third stage of labour (AMSTL) with oxytocin. Specific objective of the study was to look for incidence of Post-Partum Haemorrhage (PPH), length of 3rd stage, incidence of retained placenta and average blood loss. Methodology: A hospital based prospective, descriptive, observational study was carried out from 1st July 2005 to 30th June 2006 at department of Obstetrics and Gynaecology, Kathmandu Medical College Teaching Hospital (KMCTH). All patients undergoing vaginal delivery excluding twins, polyhydraminios and instrumental deliveries were included in the study. The active management of 3rd stage included administration of 10 units IU of oxytocin, early cord clamping, controlled cord traction and uterine massage. Blood loss was estimated by visual inspection and measured by jar pressed against perineum. Result: Total number of deliveries during the study period was 530. There were 13 cases of PPH. Incidence of PPH was 2.4%. There were six cases each of uterine atony and genital tract trauma. One case was of retained placenta requiring Manual Removal (MRP). Average third stage duration was less than 5 minutes. Average blood loss was 90 ml. In 2 cases the third stage lasted more than 30 mins. Conclusion: Active management of 3rd stage of labour reduces the incidence of PPH from uterine atony, reduces the duration as well as average blood loss during third stage.condition. Key words: Labor analgesia; epidural, combined spinal epidural; complications, dural puncture, postdural puncture headache (PDPH); prevention.   doi:10.3126/njog.v1i2.1490 N. J. Obstet. Gynaecol Vol. 1, No. 2, p. 25 - 27 Nov-Dec 2006

scholarly journals Third stage of labour: expectant versus active management-a comparative study in local low risk population

2019 ◽  
Vol 8 (2) ◽  
pp. 641
Author(s):  
Kavita A. Chandnani ◽  
Deepti D. Sharma
Keyword(s):  
Blood Loss ◽  
Comparative Study ◽  
Maternal Mortality ◽  
Post Partum ◽  
Expectant Management ◽  
Active Management ◽  
Research Centre ◽  
Third Stage ◽  
Group A ◽  
Group B

Background: Postpartum haemorrhage (PPH) is the leading cause of maternal mortality, accounting for about 35% of all maternal deaths. These deaths have a major impact on the lives and health of the families affected. Thus, anticipation as well as proper management of 3rd stage of labour is mandatory. The objective of this study was to compare expectant and active management of third stage of labour in preventing post-partum blood loss and having impact on prevention of maternal mortality in local population. Advantages and disadvantages of both techniques might be over estimated.Methods: Prospective comparative study carried out in Obstetrics and Gynecology department of SBKSMIRC (Shrimati Bhikhiben Kanjibhai Shah Medical Institute and Research Centre), Dhiraj general hospital, comprising of 200 laboring women admitted directly or from OPD to labour room for expected vaginal delivery. They were randomly allocated to group A (expectant management) and group B (active management). Labour progress was charted on partograph and interventions recorded. Statistical analysis of data was done after compiling and tabulation of data. Mean±SD for descriptive variables were calculated and appropriate statistical tests applied to determine significance.Results: Average PPBL (post-partum blood loss) was 360.5ml in group A as compared to 290.6ml in group B. 12 patients in group A had blood loss more than 500ml while none in group B. 66% cases in group B had duration of third stage of labour less than 5 min as compared to only 22% in group A. the mean duration of third stage was 13.46±8.3 in group A while 5.32±3.05 in group B. these differences were statistically significant.Conclusions: Active management of the third stage of labour is associated with less blood loss as well as a shorter duration of third stage compared with expectant management. It is reasonable to advocate this regime.

scholarly journals A Comparative Study of Oxytocin & Misoprostol in Active Management of Third Stage of Labour

2015 ◽  
Vol 12 (1) ◽  
pp. 22-24
Author(s):  
N Ansari ◽  
CR Das
Keyword(s):  
Blood Loss ◽  
College Teaching ◽  
Cross Sectional Study ◽  
Active Management ◽  
Cross Sectional ◽  
Medical College ◽  
Significant Difference ◽  
Third Stage ◽  
Group A ◽  
Group B

Introduction: The third stage of labour is the period which follows the completed delivery of the foetus and consists of delivery of the placenta and its attached membranes.Aims and objectives: Comparison of oxytocin & misoprostol in active management of third stage of labour.Material and Methods: This is a comparative cross-sectional study was conducted in Nepalgunj Medical College Teaching Hospital, Kohalpur from March 2013 to March 2014. Group A - Oxytocin 10 IU IV bolus in 100 patients and Group B - Misoprostol 600 micro gram rectally. The collected were subjected to statistical analysis using SPSS 15.Results: After active management with bolus oxytocin, the blood loss was grossly reduced being 40-100ml in 84% cases and only 7% had blood loss more than 100ml. blood loss between 200-300ml were only 6% and only 3% had PPH, after misoprostol 80% of cases had blood loss within 40 – 100 ml., 6% cases had blood loss within 100 – 200 ml. and larger amount of blood loss i.e. between 200 – 300 ml. was observed in 7% cases, in 3% cases blood loss was between 300 – 400 ml. and 4% of women in this group had PPH.Conclusion: There was no statistically significant difference in the efficacy of oxytocin and misoprostol in reducing amount of blood loss and duration of labour rd in 3 stage of labour.Journal of Nepalgunj Medical College Vol.12(1) 2014: 22-24

scholarly journals Active management of third stage of labour: comparison between prophylactic intramuscular methylergometrine and intramuscular oxytocin

1970 ◽  
Vol 2 (2) ◽  
pp. 24-28 ◽  
Author(s):  
Shilu Adhikari ◽  
Ashma Rana ◽  
Kesang D Bista
Keyword(s):  
Side Effects ◽  
Blood Transfusion ◽  
Blood Loss ◽  
Postpartum Hemorrhage ◽  
Post Partum ◽  
Statistical Significance ◽  
Active Management ◽  
Normal Vaginal Delivery ◽  
The Third ◽  
Third Stage

Aim: Aimed at comparing the efficacy of prophylactic intramuscular methylergometrine with intramuscular oxytocin in reducing blood loss in the third stage of labour (TSL). Methods: This is a randomized, comparative, clinical trial to compare the efficacy of intramuscular methylergometrine with intramuscular oxytocin in the third stage of labour for the prevention of postpartum hemorrhage Two hundred women undergoing normal vaginal delivery were recruited, 100 in each group- Group A receiving .2mg methylergometrine intramuscularly and Group B receiving 10U oxytocin intramuscularly immediately after the delivery of the anterior shoulder of the baby. The efficacy and the safety of these two drugs were analyzed on the basis of percentages fall in haemoglobin (Hb) and haematocrit (Hct) level from before delivery to 24 completed hours after delivery, need for additional uterotonic agents, need for exploration and uterine evacuation, need for blood transfusion, duration of third stage of labour and the numbers of retained placenta and need for MRP. Results: Intramuscular methylergometrine was observed to be equally effective as intramuscular oxytocin in prevention of post partum haemorrhage (PPH) [defined as fall in Hb and /or Hct level³ 10% from before delivery to 24 hours after delivery]. There was no difference in the risk of prolonged third stage, need for additional uterotonic agents, need for exploration and uterine evacuation and need for blood transfusion in the two groups. The side effects were all mild in nature and the overall incidence was too low for statistical significance to be elicited. Conclusion: Intramuscular methylergometrine is as efficacious as intramuscular oxytocin in the prevention of third stage blood loss with comparable side effects. Keywords: Third stage of labour, postpartum hemorrhage, methylergometrine, oxytocin.   doi:10.3126/njog.v2i2.1451   N. J. Obstet. Gynaecol 2007 Nov-Dec; 2 (2): 24 - 28

scholarly journals A study to assess the effectiveness of initiation of breast feeding during third stage of labour among mothers on their physiological parameters at selected sub-divisional Hospital in West Bengal

2020 ◽  
Vol 10 (1) ◽  
pp. 285
Author(s):  
Jyotsna Bag ◽  
Sima De
Keyword(s):  
Blood Loss ◽  
Breast Feeding ◽  
Vital Signs ◽  
Sampling Technique ◽  
General System ◽  
Structured Interview ◽  
Control Group ◽  
Validity And Reliability ◽  
Significant Difference ◽  
Third Stage

Background: There is paucity of Indian literature regarding effect of early breast feeding in subsequent course of labour. So, this study was undertaken to find out the effectiveness of early initiation of breast feeding during third stage of labour on the duration of labour, amount of blood loss during labour and nature of placental expulsion, along with the changes in vital signs during second and third stages of labour among mothers of both experimental and control groups.Methods: A quasi experimental post-test only control group study design was adopted. The conceptual framework for the study was based on general system model. Non-probability purposive sampling technique was used to select 20 intra-natal mothers and 10 mothers were randomly assigned to experimental group and another 10 mothers were randomly assigned to the control group. A structured interview schedule, observation checklist on progress of 1st, 2nd, and 3rd stages of labour, measurement of blood loss and measurement of vital signs were used to collect data after establishing validity and reliability of the tools.Results: The finding of the study revealed that there was significant difference in duration of 3rd stage of labour, t (18)=5.237 at 0.05 level and blood loss during 3rd and 4th stage of labour, a t (18)=3.95 at 0.05 level. There was true difference in pulse rate but not the respiration rate and blood pressure.Conclusions: Initiation of breast feeding during third stage of labour is effective in reducing maternal morbidity and mortality.

scholarly journals Use of Oral Misoprostol, Intramuscular Oxytocin and Intravenous Methergin in Prevention of Postpartum Haemorrhage

2013 ◽  
Vol 8 (1) ◽  
pp. 34-36
Author(s):  
Banwari Lal Meena
Keyword(s):  
Blood Transfusion ◽  
Blood Loss ◽  
Post Partum ◽  
Active Management ◽  
P Value ◽  
Multi Centre Study ◽  
Oral Misoprostol ◽  
Third Stage ◽  
Group B ◽  
A Prospective Study

Aims: The purpose of the study was to compare the efficacy of misoporstol 600mg orally (Group A), injection oxytocin 10 IU intramuscularly (Group B) and injection methylergometrine 0.2 mg intravenously (Group C) on reducing blood loss in third stage of labour, duration of third stage of labour, effect on haemoglobin of the patient, need of additional oxytocics or blood transfusion and associated side effects and complications. Methods: A prospective study enrolling 510 women and randomising them into three groups was done in S P Medical College, Bikaner, Rajasthan, India. Active management of third stage of labour was done using one of the three uterotonics as per the group of the patient. Results: Methylergometrine was superior to rest of the drugs with lowest duration of third stage of labour (p = 0.02), lowest amount of blood loss (p = 0.0001) and lowest rate of post partum hemorrhage (p = 0.08). The need of additional oxytocics and blood transfusion was highest with oral misoprostol as compared to all other drugs used in the study with p value of 0.08 and 0.009 respectively. Conclusions: Methylergometrine has the best uterotonic drug profile amongst the drugs used, strongly favouring its routine use as oxytocic for active management of third stage of labour. Oral misoprostol resulted in a higher blood loss compared to other drugs and hence it should be used only in low-resource settings where other drugs are not available. However, a large multi-centre study is needed for the confirmation of the finding. Nepal Journal of Obstetrics and Gynaecology / Vol 8 / No. 1 / Issue 15 / Jan- June, 2013 / 34-36 DOI: http://dx.doi.org/10.3126/njog.v8i1.8859

scholarly journals Carbetocin and Oxytocin in the Active Management of third Stage of Labor after Vaginal Birth of Baby

2017 ◽  
Vol 46 (1) ◽  
pp. 7-10
Author(s):  
Hena Rani Barua ◽  
Rita Rani Barua ◽  
Sushanta Barua ◽  
Ajoy Kishore Barua ◽  
Kohinoor Begum
Keyword(s):  
Post Partum ◽  
Active Management ◽  
College Hospital ◽  
Mortality And Morbidity ◽  
The Third ◽  
Third Stage Of Labor ◽  
Significant Difference ◽  
Third Stage ◽  
Group 2 ◽  
Group 1

Postpartum hemorrhage (PPH) is one of the major contributors to maternal mortality and morbidity worldwide. Active management of the third stage of labor has been proven to be effective in the prevention of PPH. Carbetocin; a long-acting Oxytocin agonist appears to be a promising agent for the prevention of PPH. In this study Carbetocin is used for the active management of third stage of labor to prevent PPH. Two hundred pregnant women from July 2015 to December 2015 at Rangamati Medical College Hospital, Rangamati, Bangladesh were included in this study. The patients were divided into two groups: Group- 1 (100 women) were received 100μg Carbetocin intravenously and group- 2 (100 women) received 10 IU Oxytocin intramuscularly and both doses were single. These uterotonics were injected at anterior shoulder after the delivery of the baby. Significant difference was observed between the Carbetocin and Oxytocin receiving groups regarding amount of blood loss (335.70 ± 117.71 versus 375.12 ± 145.30), PPH (3 % versus 12%), need of use of other uterotonics (18% versus 30%) and the difference in hemoglobin percent before and after delivery (0.58 ± 0.34 versus 0.97± 0.52). All these parameters were lower in Carbetocin group except hemoglobin level which is higher in group- 2 during 24 hours after delivery. Moreover, blood transfusion was not indicated in group- 1. In conclusion, Carbetocin is superior to Oxytocin in prevention of post partum hemorrhage at the third stage of vaginal delivery with minimal homodynamic changes and side effects.Bangladesh Med J. 2017 Jan; 46 (1): 7-10

scholarly journals HUBUNGAN MANAJEMEN AKTIF KALA III DENGAN KEJADIAN PERDARAHAN POST PARTUM PRIMER DI PBM UMI SURABAYA

2020 ◽  
Vol 3 (1) ◽  
pp. 35
Author(s):  
Sulenti Widiastutik
Keyword(s):  
Health Services ◽  
Health Workers ◽  
Post Partum ◽  
Sampling Technique ◽  
Active Management ◽  
Chi Square ◽  
Cross Sectional ◽  
Post Partum Hemorrhage ◽  
The Third ◽  
Third Stage

ABSTRAK ABSTRAK         Manajemen akif kala III merupakan suatu intervesi yang sangat penting dilakukan pada setiapasuhan persalinan normal dengan tujuan menurunkan angka kemati ibu. Sebagian besar kasus perdarahan terjadi selama persalinan kala III salah satunya seperti atonia uteri.         Dalam penelitian ini menggunakan metode analitik observasional, dengan desain penelitian ini bersifat “ cross sectional “ populasi penelitian ini sebanyak  60 ibu bersalin di PBMUmi Surabaya.Hasil penelitian menunjukkan bahwa manajemen aktif kala III dilakukan dengan sempuirna sebanyak 36 ibu  bersalin.(60%) dan ibu bersalin yang tidak mengalami perdarahan post partum primer sebanyak 33 ibu (55%) Populasi dalam penelitian ini adalah semua ibu  yang bersalin di PBM Umi Surabayadengan besar sampel sebanyak 60 ibu bersalin dengan tehnik total sampling.Dari hasil analisis data menggunakan chi square menunjukkan hasil   hitung (21,237) >  tabel (3,84) = Ho ditolak H1 diterima. Sehingga ada hubungan manajemen aktif kala III dengan kejadian perdarahan post partum primer di PBM Umi Surabaya        Upaya percepatan penurunan  AKI dapat dilakukan dengan menjamin agar setiap ibu mampu mengakses pelayanan kesehatan ibu yang berkwalitras, seperti pelayanan kesehatan ibu hamil, pertolongan persalinan oleh tenaga kesehatan terlatih, dan perawatan pasca persalinan ibu dan bayi, perawatan khusus dan rujukan jika terjadi komplikasi Kata kunci Manajemen aktif kala III, Perdarahan Post Paetum PrimerABSTRACTThe third stage of active management is a very important intervention performed in every normal childbirth care with the aim of reducing maternal mortality. Most cases of bleeding occur during the third stage of labor such as uterine atony.         In this study using observational analytic methods, the design of this study is "cross sectional" in this study population of 60 women giving birth in PBM Umi Surabaya.The results showed that the active management of the third stage was carried out with up to 36 mothers (60%) and women who did not experience primary post partum hemorrhage as many as 33 mothers (55%). a large sample of 60 mothers with total sampling technique. From the results of data analysis using chi square showed the results of X2 count (21,237)> X2 table (3.84) = Ho rejected H1 accepted. So there is an active management relationship between the third stage and the incidence of primary post partum hemorrhage at PBM Umi Surabaya        Efforts to accelerate the reduction of MMR can be done by ensuring that every mother is able to access quality maternal health services, such as health services for pregnant women, delivery assistance by trained health workers, and postpartum care for mothers and babies, special care and referrals if complications occur. Keywords Active management stage III, Primary Post Partum Bleeding

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