EFFICACY OF RECTAL MISOPROSTOL WHEN COMBINED WITH STANDARD OXYTOCIN TO TREAT POSTPARTUM HEMORRHAGE

Background: One of the commonest causes of maternal mortality in the developing world is post-partum hemorrhage. In Pakistan it accounts for nearly 25% of maternal deaths. This trial was conducted to study the effectiveness and safety of rectal misoprostol in the treatment of post-partum hemorrhage.Material Methods: This study was conducted at DHQ Teaching Hospital D.I.Khan from January 2007 to December 2007. Women with more than usual postpartum hemorrhage due to inadequate uterine contrac¬tions were enrolled after informed consent. Women having contra-indication to the use of oxytocin or misoprostol were excluded from the study. They were given tablet misoprostol 800 microgram rectally, and blood loss measured for at least one hour of postpartum hemorrhage. The primary outcome measure was total blood loss and blood transfusion while secondary outcome measure was medication side effects.Results: During the study period 2011 deliveries occurred and 80 women were eligible for the study. Fifty- five of these were given rectal misoprostol and 25 were taken as controls. The demographic characteristics of both the groups were similar. There was a significant difference in blood loss of 1000 ml (p 0.001). Pyrexia was more common in misoprostol group 22% vs 16% p 0.05.Conclusion: Misoprostol is an effective treatment for postpartum hemorrhage