THE ROLE OF PROSTAGLANDINS IN THE MANAGEMENT OF PRIMARY POSTPARTUM HAEMORRHAGE DUE TO UTERINE ATONY / HYPOTONY AND THE IMPACT OF THEIR USE ON THE NEED FOR OBSTETRICAL HYSTERECTOMY

Objective: To evaluate the role of prostaglandin F2 alpha in the management of primary post partum haemorrhage due to uterine atony and to judge the impart of their use on the need for obstetrical hysterectomy.Material and Methods: This retrospective study was conducted in Department of obstetrics and gynaecology, unit (Bʹ unit Khyber teaching Hospital Peshawar. Duration was one year 1st July 2001 to 30th June 2002. Date collection was done of a total of 70 patient who presented with or developed PPH during the year. 40 patients were excluded as they had trauma to the birth canal. 30 patients with uterine atony were considered. Methods of management, haemodynamic stability and surgery were assessed, and the use of prostaglandin F2 alpha taken into consideration and effects judged and results were compiled.Results: Out of a total of 30 patients conventional management was successful in 14 and failed in 16 in whom PG F2 alpha was tried and was successful in 14 cases. 28 (93.5%) patients out of 30 did not need surgery 2 (6.6%) needed surgical intervention.Conclusion: Results showed that prostaglandin is a very effective agent for control of primary post partum haemorrhage and its use results in decrease for the need of major surgical interventions like hysterectomy, internal illiac artery or uterine artery ligation in an already compromised patient.