This search included 150 pregnant women who had gestational age of 36 weeks or more, and had been admitted to the Department of Obstetrics and Gynecology at Al – Assad University Hospital in Lattakia for the spontaneous vaginal delivery during the st
udy period
( 1\1\2012 to 1\7\ 2013). Exclusion criteria were patients undergoing cesarean section, patients with placenta previa, or abruptio placenta, patients with hemoglobin<9 gm%, pregnancy-induced hypertension or pre eclampsia–eclampsia, grand multiparty, coagulation abnormalities, positive history of PPH, expensive hemorrhage or other medical disorders.
Patients were randomly divided into three groups: ( 1: uterine massage group, 2: 10 units oxytocin in 500 cc glucose 5% intravenously with delivery of the anterior sholder\ control group, 3: three 200µg rectal misoprostol tablets\study group).
No significant differences were observed between the groups regarding baseline characteristics. There was blood loss of ≥500 ml occurred in 18% in the first group, 6% in the second group, 8% in the third group. Routine use of 600 µg of rectal misoprostol was effective in reducing blood loss after delivery ل gm%, pregnancyts with hemoglobin}ergoing cesarean section, patients with placenta pre and g (RR 0.44 ; CI 0.32 – 1.53), but not as effective as intravenous oxytocin (RR 1.33 ; CI 0.4 – 3.39).
Although these were differences, they were not significant (No significant differences were observed between the control and study groups for the length of the third stage of labor, the estimated blood loss, the changes in Hb and Hct concentrations, need for additional uterotonics, manual removal of placenta, blood transfusion…..).
This dose of misoprostol and route of administration were well tolerated, and usual side effects such as shivering and fever were transient, resolved on their own, and were not threatening. Because PPH is the most significant direct cause of maternal mortality and because most of these maternal mortality occurs in low resource countries, misoprostol offers several advantages over oxytocin in such settings. It is formulated as a tablet, widely available and affordable, and it does not need require special storage conditions (i.e. it is stable at ambient room temperature and does not require specific conditions for transfer and has a shelf-life of several years). It also does not require any special skills, equipment, or facilities for its use. So misoprostol can fill a service delivery gap in settings where women and providers are unable to access oxytocin.ل gm%, pregnancyts with hemoglobin}ergoing cesarean section, patients with placenta pre and g
This study was organized to find out the role and the efficacy of Misoprostol
in treating postpartum hemorrhage unresponsive to traditional agents that
contract the uterus .
Place : Maternity hospital at Faculty of Medicine in Damascus university
Time : from 2, January, 2004 to 2, January, 2005 .
Number of patients : 18 patients who met the criteria in that period of time .
Criteria of selection : any patient with post partum hemorrhage due to
uterine atony that did not respond well to the administration of Oxytocin
and Metergin .
Misoprostol is an effective treatment of post partum hemorrhage due to
uterine atony unresponsive to Oxytocin and Metergin.
Our study confirms the results of international studies of effectiveness of the
use of misoprostol in treating post partum hemorrhage due to uterine atony.
Objective: To compare the effectiveness of Misoprostol administered
intravaginally every 12 versus 6 hours for termination of pregnancy in the
first and second trimesters.
Methods: Fifty six pregnant patients at 7 – 22 weeks of gestation were
ran
domized to receive 800 μg (first trimester) and 200 μg either every 12 or
every 6 hours for 48 hours.
Results: The incidence of abortion within 48 hours after initial dose, in the
first trimester was 100% in the two groups, in the second trimester the
incidences were 95.5 and 100%. The incidences of abortion by a single dose
in the first trimester were 85 and 10% in the 12 and 6 hours groups
respectively (P <0.001) The mean abortion intervals 8.3 , 20.2 and 12.4
hours in the 12 and 6 hour group respectively. Side effects were similar in
both groups.
Conclusion: Misoprostol administered vaginally is effective for termination
of first and second trimester pregnancies in non scared uterus. Giving the
medication at a shorter interval from 12 to 6 hours appeared to have no
significant benefit.
