Different Doses of Sublingual Misoprostol versus Methylergometrine for the Prevention of
Abstract
Objective: In the poor underdeveloped countries, anaemia is very common in pregnant women. Maternal mortality is four times
higher in severely anaemic women than non-anaemic ones and postpartum haemorrhage (PPH) is the most common cause of
death. Its main cause is uterine atony, which accounts for more than 70%. The objective of this study is to evaluate the use of
sublingual misoprostol in different doses of 600, 800 and1000μg in management of the third stage of labor, with regards to
blood loss and incidence of atonic postpartum haemorrhag (APPH).
Study Design: Double blind randomized controlled study
Methods : One thousand and two hundred parturient were studied in a control and three study groups, each composed of 300
women. Methylergometrine 0.2 mg IM injection and sublingual misoprostol 600, 800 and 1000 μg tablets were given to women
in control and the three study groups respectively, immediately after delivery.
Outcome Measures:
Duration of the third stage of labour, Blood loss in the third stage of labour, Outcomes in anaemic compared to non-anaemic
women , Incidance of atonic postpartum haemorrhage in different groups,
Haemoglobin deficit after 24 hrs of delivery, Changes in the women’s blood pressure during the study,
Side effects of the drug, and, Women’s acceptability of sublingual misoprostol administration.
Results : Only significant reduction in blood loss and haemoglobin deficits were seen in the third stage of labour and after
delivery in women used misoprostol doses of 800 μg and 1000 μg. The incidences of PPH in studied women and controls were
almost similar, ranging between 2 and 3%. Similar results were seen in anaemic and non-anaemic women with a higher
incidence of APPH in the non-misoprostol user anaemic women. Side effects of the drug were dose related.
Conclusion : Misoprostol in high dose may be used for managing third stage of labour to reduce maternal morbidity and
mortality due to APPH particularly, in the poor underdeveloped countries where, facilities to deliver in health centers, purchase
and store the oxytocic ampoules or medically trained persons are not readily available in all places. Benefits of large dose
misoprostol outweigh its side effects.
higher in severely anaemic women than non-anaemic ones and postpartum haemorrhage (PPH) is the most common cause of
death. Its main cause is uterine atony, which accounts for more than 70%. The objective of this study is to evaluate the use of
sublingual misoprostol in different doses of 600, 800 and1000μg in management of the third stage of labor, with regards to
blood loss and incidence of atonic postpartum haemorrhag (APPH).
Study Design: Double blind randomized controlled study
Methods : One thousand and two hundred parturient were studied in a control and three study groups, each composed of 300
women. Methylergometrine 0.2 mg IM injection and sublingual misoprostol 600, 800 and 1000 μg tablets were given to women
in control and the three study groups respectively, immediately after delivery.
Outcome Measures:
Duration of the third stage of labour, Blood loss in the third stage of labour, Outcomes in anaemic compared to non-anaemic
women , Incidance of atonic postpartum haemorrhage in different groups,
Haemoglobin deficit after 24 hrs of delivery, Changes in the women’s blood pressure during the study,
Side effects of the drug, and, Women’s acceptability of sublingual misoprostol administration.
Results : Only significant reduction in blood loss and haemoglobin deficits were seen in the third stage of labour and after
delivery in women used misoprostol doses of 800 μg and 1000 μg. The incidences of PPH in studied women and controls were
almost similar, ranging between 2 and 3%. Similar results were seen in anaemic and non-anaemic women with a higher
incidence of APPH in the non-misoprostol user anaemic women. Side effects of the drug were dose related.
Conclusion : Misoprostol in high dose may be used for managing third stage of labour to reduce maternal morbidity and
mortality due to APPH particularly, in the poor underdeveloped countries where, facilities to deliver in health centers, purchase
and store the oxytocic ampoules or medically trained persons are not readily available in all places. Benefits of large dose
misoprostol outweigh its side effects.
Soltan, M., El-Gendi, E., Imam, H., & Fathi, O. (2007). Different Doses of Sublingual Misoprostol versus Methylergometrine for the Prevention of. International Journal of Health Sciences, 1(2). Retrieved from https://pub.qu.edu.sa/index.php/journal/article/view/93
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