SUBLINGUAL MISOPROSTOL FOR PREVENTION OF POSTPARTUM HAEMORRHAGE – A RANDOMISED CONTROL TRIAL

Abstract

Aim – The aim of the study was to study the effect of sublingual misoprostol for prevention of PPH.\nMaterials and Methods – This was a prospective, randomized, double blind, placebo controlled study. Inclusion criteria were women aged 20-40\nyears with 38-40 weeks of gestation who underwent elective caesarean section. Exclusion criteria were women have risk factors for post-partum\nhaemorrhage, active thromboembolic disease and intrinsic risk for thrombosis. Participants were randomly assigned to misoprostol group or group\nA (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\nplacebo 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\nhours postpartum, haemoglobin estimation was done in all patients pre operatively and 24 hours post operatively and the change in concentration\nwas noted. Secondary outcome measures were need for additional uterotonics, use of additional surgical interventions to control post-partum\nhaemorrhage.\nResult – Blood loss from both placental delivery to the end of caesarean section and from end of caesarean section to 2 hours postpartum were\nsigni\uf001cantly lower in the study group. (p<0.0001). Change ifn haemoglobin concentration in study group was also signi\uf001cantly less than in the\ncontrol group. (p<0.0001). Total amount of Oxytocin required was signi\uf001cantly less in the study group (p=0.01). The number of women requiring\nother oxytocics (inj. Methyl ergometrine, inj. Carboprost) was signi\uf001cantly less in study group (p=0.0078).\nConclusion – Sublingual misoprostol has been found to be effective in preventing PPH.