Prophylactic Administration of Per Rectal Misoprostol vs Intramuscular Injection of Oxytocin in Third-stage of Labour for Prevention of Postpartum Haemorrhage: A Randomised Controlled Trial
Introduction: In India, the routine Active Management of ThirdStage of Labour (AMTSL) with conventional intramuscular oxytocin, at the rural, resource-constrained areas, is often compromised due to lack of trained healthcare personnel and proper maintenance of cold chain system, causing maternal...
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JCDR Research and Publications Private Limited
2021
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oai:doaj.org-article:d721309ec20d4a05bf399ce27b7477d32021-11-12T12:21:30ZProphylactic Administration of Per Rectal Misoprostol vs Intramuscular Injection of Oxytocin in Third-stage of Labour for Prevention of Postpartum Haemorrhage: A Randomised Controlled Trial10.7860/JCDR/2021/50020.153872249-782X0973-709Xhttps://doaj.org/article/d721309ec20d4a05bf399ce27b7477d32021-09-01T00:00:00Zhttps://www.jcdr.net/articles/PDF/15387/50020_CE[Ra1]_F[SK]_PF1(JY_SH_KM)_PFA(JY_KM)_PN(KM).pdfhttps://doaj.org/toc/2249-782Xhttps://doaj.org/toc/0973-709XIntroduction: In India, the routine Active Management of ThirdStage of Labour (AMTSL) with conventional intramuscular oxytocin, at the rural, resource-constrained areas, is often compromised due to lack of trained healthcare personnel and proper maintenance of cold chain system, causing maternal mortality and morbidity from Postpartum Haemorrhage (PPH). In these scenarios, tablet misoprostol, can be efficacious and convenient alternative. Aim: To evaluate efficacy and safety of misoprostol administered per rectum with respect to intramuscular oxytocin for effective control of PPH in a Randomised Controlled Trial (RCT). Materials and Methods: In this RCT, conducted in Sambhunath Pandit Hospital, kolkata, West Bengal, India from September 2015 to August 2016, total 80 eligible pregnant mothers in normal labour with prior consent and fulfilled criteria, were allocated to two separated groups (n=40) by computer generated randomisation table. Control group received 10 IU injection oxytocin and case group received 600 μg misoprostol tablet per rectally within one minute of cord clamping and cutting. The primary outcome measures were mean thirdstage and mean postpartum blood loss up to eight hours after delivery. Secondary outcome variables were Mean Arterial Pressure (MAP) after eight hours postdelivery, haemoglobin and haematocrit after 24 hours of delivery and reported side effects. Data was entered into a Microsoft excel spreadsheet and statistical analysis was done by Statistical Package for the Social Sciences (SPSS) version 20.0.1 and Graph Pad Prism version 5.0. Results: Total sample size was 80 equally divided into two groups, with a mean age of 23.20±3.1558 years and 23.7750±3.8927 years in case and control group respectively. The mean third-stage blood loss (332.4105±72.6632 mL versus {vs} 329.0088±59.4503 mL, p=0.8193) and mean total blood loss (426.5575±80.0215 mL vs 424.8783±61.5808 mL, p=0.9165) were statistically indifferent between misoprostol and oxytocin groups by two-sample t-tests. The mean for eight hours postpartum MAP (p=0.0894), 24 hours postpartum haemoglobin (p=0.4534) and haematocrit (p=0.1325) were statistically insignificant between the two groups by twosample t-tests. Incidence of adverse effects like shivering, diarrhoea, compared by Pearson’s Chi-square test, were found to be more but non significant in misoprostol group. Conclusion: This study concludes that per-rectal misoprostol is equally effective as intramuscular oxytocin to control PPH without significant adverse effects.Sougata Kumar BurmanRitwik SamantaKumari Kanak LataJayeeta MukherjeeTapan Kumar DeyJCDR Research and Publications Private Limitedarticleactive management of third-stage of labourresource-constraintssafetyuterotonicsMedicineRENJournal of Clinical and Diagnostic Research, Vol 15, Iss 9, Pp QC09-QC13 (2021) |
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EN |
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active management of third-stage of labour resource-constraints safety uterotonics Medicine R |
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active management of third-stage of labour resource-constraints safety uterotonics Medicine R Sougata Kumar Burman Ritwik Samanta Kumari Kanak Lata Jayeeta Mukherjee Tapan Kumar Dey Prophylactic Administration of Per Rectal Misoprostol vs Intramuscular Injection of Oxytocin in Third-stage of Labour for Prevention of Postpartum Haemorrhage: A Randomised Controlled Trial |
| description |
Introduction: In India, the routine Active Management of ThirdStage of Labour (AMTSL) with conventional intramuscular oxytocin,
at the rural, resource-constrained areas, is often compromised due
to lack of trained healthcare personnel and proper maintenance
of cold chain system, causing maternal mortality and morbidity
from Postpartum Haemorrhage (PPH). In these scenarios, tablet
misoprostol, can be efficacious and convenient alternative.
Aim: To evaluate efficacy and safety of misoprostol administered
per rectum with respect to intramuscular oxytocin for effective
control of PPH in a Randomised Controlled Trial (RCT).
Materials and Methods: In this RCT, conducted in Sambhunath
Pandit Hospital, kolkata, West Bengal, India from September
2015 to August 2016, total 80 eligible pregnant mothers in
normal labour with prior consent and fulfilled criteria, were
allocated to two separated groups (n=40) by computer
generated randomisation table. Control group received 10 IU
injection oxytocin and case group received 600 μg misoprostol
tablet per rectally within one minute of cord clamping and
cutting. The primary outcome measures were mean thirdstage and mean postpartum blood loss up to eight hours after
delivery. Secondary outcome variables were Mean Arterial
Pressure (MAP) after eight hours postdelivery, haemoglobin
and haematocrit after 24 hours of delivery and reported side
effects. Data was entered into a Microsoft excel spreadsheet
and statistical analysis was done by Statistical Package for the
Social Sciences (SPSS) version 20.0.1 and Graph Pad Prism
version 5.0.
Results: Total sample size was 80 equally divided into two groups,
with a mean age of 23.20±3.1558 years and 23.7750±3.8927
years in case and control group respectively. The mean third-stage
blood loss (332.4105±72.6632 mL versus {vs} 329.0088±59.4503
mL, p=0.8193) and mean total blood loss (426.5575±80.0215 mL
vs 424.8783±61.5808 mL, p=0.9165) were statistically indifferent
between misoprostol and oxytocin groups by two-sample t-tests.
The mean for eight hours postpartum MAP (p=0.0894), 24 hours
postpartum haemoglobin (p=0.4534) and haematocrit (p=0.1325)
were statistically insignificant between the two groups by twosample t-tests. Incidence of adverse effects like shivering, diarrhoea,
compared by Pearson’s Chi-square test, were found to be more
but non significant in misoprostol group.
Conclusion: This study concludes that per-rectal misoprostol
is equally effective as intramuscular oxytocin to control PPH
without significant adverse effects. |
| format |
article |
| author |
Sougata Kumar Burman Ritwik Samanta Kumari Kanak Lata Jayeeta Mukherjee Tapan Kumar Dey |
| author_facet |
Sougata Kumar Burman Ritwik Samanta Kumari Kanak Lata Jayeeta Mukherjee Tapan Kumar Dey |
| author_sort |
Sougata Kumar Burman |
| title |
Prophylactic Administration of Per Rectal Misoprostol vs Intramuscular Injection of Oxytocin in Third-stage of Labour for Prevention of Postpartum Haemorrhage: A Randomised Controlled Trial |
| title_short |
Prophylactic Administration of Per Rectal Misoprostol vs Intramuscular Injection of Oxytocin in Third-stage of Labour for Prevention of Postpartum Haemorrhage: A Randomised Controlled Trial |
| title_full |
Prophylactic Administration of Per Rectal Misoprostol vs Intramuscular Injection of Oxytocin in Third-stage of Labour for Prevention of Postpartum Haemorrhage: A Randomised Controlled Trial |
| title_fullStr |
Prophylactic Administration of Per Rectal Misoprostol vs Intramuscular Injection of Oxytocin in Third-stage of Labour for Prevention of Postpartum Haemorrhage: A Randomised Controlled Trial |
| title_full_unstemmed |
Prophylactic Administration of Per Rectal Misoprostol vs Intramuscular Injection of Oxytocin in Third-stage of Labour for Prevention of Postpartum Haemorrhage: A Randomised Controlled Trial |
| title_sort |
prophylactic administration of per rectal misoprostol vs intramuscular injection of oxytocin in third-stage of labour for prevention of postpartum haemorrhage: a randomised controlled trial |
| publisher |
JCDR Research and Publications Private Limited |
| publishDate |
2021 |
| url |
https://doaj.org/article/d721309ec20d4a05bf399ce27b7477d3 |
| work_keys_str_mv |
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