Third Stage Of Labour And Dose Related Side Effects

BACKGROUND: Postpartum haemorrhage is a major cause of maternal death in underdeveloped countries like India, and to prevent and treat PPH is of major public health importance. AMTSL is a preventive measure and when practiced routinely, can reduce hemorrhage by up to 60 %. The aim of the present study was to evaluate the role of misoprostol in active management of the third stage of labour and to establish its dose related side effects. MATERIAL AND METHOD: The study was conducted in labour room of department of obstetrics and gynaecology , Nalanda Medical College And Hospital, Patna from 2010 to 2012 in lowrisk patients with 37-40 wks of gestation with singleton pregnancy. The patients were given oral misoprostol (600 μg ) in AMSTL instead of oxytocin. RESULT: In present study misoprostol was equally effective as other oxytocics in active management of third stage of labour in low risk patients and it offers several advantages over other oxytocics. CONCLUSION: Misoprostol can be used with comparable efficacy with other uterotonic drugs with minimal side effects, greater compliance and acceptability, and ease of administration in poor resource settings making it a good option in peripheries and rural health centers. Key Word: Oral Misoprostol, Labour And Dose Related Side Effects Third Stage Of Labour And Dose Related Side Effects 156 Int J Res Med. 2016; 5(3); 155-159 e ISSN:2320-2742 p ISSN: 2320-2734 for both the prevention and treatment of postpartum haemorrhage. (6). Though the side-effects can occasionally be lifethreatening, Misoprostol has been widely recommended to prevent PPH when other methods are not available (7) in resourcepoor settings. In our study, we have reviewed the uterotonic effect of oral misoprost (600 μg ) in AMSTL, its efficacy in view of amount of blood loss, change in Hb%, blood transfusion needed and its various side effects. MATERIAL AND METHOD This study was done to the effect of oral misoprostol (600 μg ) in the active management of third stage of labour and its adverse effects in low risk vaginal deliveries. This study was conducted in labour room of department of obstetrics and gynaecology , Nalanda Medical College And Hospital, Patna from 2010 to 2012. Total 250 patients were selected for study after informed consent. Inclusion criteria for the studied patients were: Patients in the age group of 19-30 years, Period of gestation between 37-40 wks, Parturients in the active phase of labour where acceleration of labour has not been done, Singleton pregnancy, Cephalic presentation and No antenatal complication. 600 μg oral misoprostol was given immediately after delivery of the baby. Detailed history was taken on admission to labour room, all women fulfilling the above mentioned criteria, in the active phase of labour (4 cm or more cervical dilatation) and likely to deliver during the time of study were selected and informed about the trial. Immediately after the delivery of the baby, the cord was clamped and cut. The women were asked to swallow 600 μg of oral misoprostol in third stage of labour and blood loss was measured for the first hour after delivery. Blood loss at delivery was assessed by collecting blood by kelly’s pad. Patients were observed for one hour following delivery for vital signs, and bleeding per vagina. The occurrence of side effects like nausea, vomiting, shivering, diarrhea, pyrexia and hypertension was observed within 24 hrs of delivery and were recorded. postpartum heamorrage in present study is defined as amount of blood loss>500ml and once the diagnosis was made, the patients were managed as per the needs by giving additional oxytocics drugs amount of blood loss average fall in Hb% side effects of drugs, cost of drug, its storage and its availability, blood transfusion and additional oxytocic used. Table 1: Distribution Of Cases According To Age Mean age: 23.46 Standard deviation (SD): 3.078 The maximum no. of cases (48%) who attended for delivery were 23-26 years of age in misoprostol group, but the mean was 23.46(3.078) year. Table 2: Distribution Of Cases