Misoprostol versus Oxytocin for the Prevention of Postpartum Haemorrhage among Women in Al-Thowrah Hospital, Sana'a City, Yemen

Abstract

Background: PPH is the leading cause of direct maternal death in developing countries. PPH is a real complication that should be studied and dealt with seriously. Aim: To compare the safety and efficacy of rectal misoprostol versus intravenous oxytocin in preventing PPH. Methods: A randomized control study was done for 6 months from 1st of May to 31 of October 2017. In the labor room of the obstetric unit at AMGH in Sana’a. The subjects were included 98 women divided into two groups: group I included 51 women were received 600 µg (3 tablets) misoprostol rectally and 2ml saline in Ringers lactate intravenously as placebo. Group II: included 47 women were received 30IU intravenous oxytocin in Ringers lactate and two lactose tablets rectally as placebo. The collected data for every woman, Patient kept under close observation for 4 hours, for any vaginal bleeding, nausea, vomiting, fever, shivering and etc. Then estimated of blood loss and side effects of uterotonic drugs by direct observation. Results: Incidence of PPH in the misoprostol group 23.5% was more than that found in the oxytocin group 6.4% (p-value<0.05). Risk factors were not significantly different in the two groups, except the prior history of PPH which is more in group I. Side effects: Shivering was more incidences in group I, 54.9% than group II, and 4.3%. While nausea was found in one case 2.1% in group II and no case found in group I. Pyrexia and vomiting were not found in the two groups. Additional uterotonic TTT was used to prevent PPH, within 4 hours of observation: 17.6% of group I needed 3 tablets misoprostol rectally and 6.4% of group II needed 30IU oxytocin infusion was added to prevent PPH. Conclusion: Misoprostol 600µg given rectally is less effective to control the PPH in the management of the third stage labour.