misoprostol vs metergin

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8/16/2019 Misoprostol vs Metergin http://slidepdf.com/reader/full/misoprostol-vs-metergin 1/20  Randomized comparative study of oral misoprostol with intravenous methyl ergometrine in prevention of postpartum haemorrhage in cases high risk for postpartum haemorrhage Department of Obstetrics & Gynaecology, ESIC Medical College, Kalaburagi, Karnataka, India Received: 17 January 2016 Revised: 17 e!ruary 2016 "ccepted: 22 e!ruary 2016 "isha #umera$ %udha &iradar 'erure

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     Randomized comparative study

    of oral misoprostol withintravenous methyl ergometrinein prevention of postpartum

    haemorrhage in cases high riskfor postpartum haemorrhageDepartment of Obstetrics & Gynaecology, ESIC Medical College, Kalaburagi, Karnataka,

    India

    Received: 17 January 2016Revised: 17 e!ruary 2016

    "ccepted: 22 e!ruary 2016"isha #umera$ %udha &iradar 'erure

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    (ntroduction

     regnancy and c!ildbirt! in"ol"es signi#cant!ealt! risks, e"en to $omen $it! no pre%

    eisting !ealt! problem' ()O estimated t!at*,+,--- $omen died from complications ofpregnancy and c!ildbirt!

     Se"ere bleeding or !emorr!age is t!e singlemost important cause of maternal deat!$orld$ide, !alf of $!ic! occurs $it!in +.!rsof deli"ery'

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    (ntroduction

     /!e commonest cause of postpartum!emorr!age is uterine atony'

    0y "arious studies conducted it !asbeen pro"ed t!at pre"ention of )can be ac!ie"ed by acti"emanagement of t!ird stage of labourin almost .-1 of cases

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     /ill today commonly used oytocicdrugs for pre"ention of ) are

    oytocin, ergometrine orcombination of bot! but unstable at !ig! ambient temperature,

    epensi"e

    need refrigeration for storage andtransport,

    need sterile needle and syringe for

    parenteral administration

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    Misoprostol, a synt!eticprostaglandin E2 analogue, $!ic!

    $as basically used for t!e treatmentof gastric ulcers and !as action o"ert!e uterine myometrium causing t!euterus to contract and t!us can beused for pre"ention of postpartumbleeding'

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    )isoprostol

    potential bene#ts including rapid absorption,ease of administration 3oral, rectal, sublingual4

    does not re5uire any trained personnel and can

    be administered by traditional birt! attendants,cost e6ecti"eness and no special condition for

    t!e storage and transport,!as a s!elf%life of se"eral years and t!us it

    pro"es to be a suitable uterotonic agent for usein t!e prop!ylactic management of t!ird stageof labour especially in resource%poor set%up inde"eloping countries

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    )ethods

     /!is study $as conducted in t!eDepartment of Obstetrics and

    Gynaecology at 7enepoya MedicalCollege )ospital, Mangalore duringt!e period of t$o years from8o"ember +--9 to October +--

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    Inclusion criteria

    :ll parous $omenin labour'

    Multiple fetalgestation'

    Induced oraugmented labour'

    Moderate to se"ereanaemia not infailure'

    )ydramnios'

    Exclusion criteria

    re%eclampsia andeclampsia

    re"ious caesarean

    section re"ious retained

    placenta :ntepartum !emorr!age Coagulation abnormalities regnancy complicated

    $it! medical disorderslike cardiac diseases,diabetes, !ypertensionand epilepsy'

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    2-- patients $!o ful#lled t!e

    selection criteria $ere included int!e study

    studied $it! *- cases in eac! group

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    ;:8DOM<

     7

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     /!e blood loss during t!e t!ird stage oflabour and t!e immediate postpartumperiod 32 !our after deli"ery4 $as measured

    ostpartum !emorr!age in t!e presentstudy is de#ned as blood loss =*-- ml in2st !our after deli"ery'

    Once t!e diagnosis of postpartum!emorr!age $as made, t!e patients $eremanaged as per t!e needs by gi"ingadditional oytocics drugs

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    Result

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    Result

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    Result

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    Result

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    Result

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    *onclusion

    bot! misoprostol andmet!ylergometrine are e5ually

    e6ecti"e in t!e acti"e managementof t!e >rd stage of labour in !ig! riskcases

    s!i"ering and pyreia $ere t!ecommonest side e6ects $it!misoprostol, and nausea $as t!emost common side e6ect noted in

    met!yl ergometrine

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    e"en in presence of s!i"ering $!ic! is aserious side e6ect but self%limiting $it!oral misoprostol o6ers se"eral ad"antages s!elf%life of se"eral years,

    stability at !ig! temperatures 3i'e', it does notre5uire refrigeration4 and oral administrationi'e',

    it does not re5uire needle or syringe $!ic! is ama?or ad"antage in t!e era of )[email protected] and)epatitis 0'

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     /!ese ad"antages of misoprostol make ita feasible drug to be used in routineacti"e management of t!e >rd stage of

    labour especially in de"eloping countries,$!ere *-%9-1 of deli"eries take place at!ome, far from !ospitals or medical

    facilities and are super"ised solely by birt!attendants

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    +erimakasih