misoprostol vs metergin

20
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

Upload: miaputeri

Post on 05-Jul-2018

242 views

Category:

Documents


0 download

TRANSCRIPT

Page 1: Misoprostol vs Metergin

8/16/2019 Misoprostol vs Metergin

http://slidepdf.com/reader/full/misoprostol-vs-metergin 1/20

 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

Page 2: Misoprostol vs Metergin

8/16/2019 Misoprostol vs Metergin

http://slidepdf.com/reader/full/misoprostol-vs-metergin 2/20

(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'

Page 3: Misoprostol vs Metergin

8/16/2019 Misoprostol vs Metergin

http://slidepdf.com/reader/full/misoprostol-vs-metergin 3/20

(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

Page 4: Misoprostol vs Metergin

8/16/2019 Misoprostol vs Metergin

http://slidepdf.com/reader/full/misoprostol-vs-metergin 4/20

 /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

Page 5: Misoprostol vs Metergin

8/16/2019 Misoprostol vs Metergin

http://slidepdf.com/reader/full/misoprostol-vs-metergin 5/20

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'

Page 6: Misoprostol vs Metergin

8/16/2019 Misoprostol vs Metergin

http://slidepdf.com/reader/full/misoprostol-vs-metergin 6/20

)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

Page 7: Misoprostol vs Metergin

8/16/2019 Misoprostol vs Metergin

http://slidepdf.com/reader/full/misoprostol-vs-metergin 7/20

)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 +--

Page 8: Misoprostol vs Metergin

8/16/2019 Misoprostol vs Metergin

http://slidepdf.com/reader/full/misoprostol-vs-metergin 8/20

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'

Page 9: Misoprostol vs Metergin

8/16/2019 Misoprostol vs Metergin

http://slidepdf.com/reader/full/misoprostol-vs-metergin 9/20

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

selection criteria $ere included int!e study

studied $it! *- cases in eac! group

Page 10: Misoprostol vs Metergin

8/16/2019 Misoprostol vs Metergin

http://slidepdf.com/reader/full/misoprostol-vs-metergin 10/20

;:8DOM<

 7

Page 11: Misoprostol vs Metergin

8/16/2019 Misoprostol vs Metergin

http://slidepdf.com/reader/full/misoprostol-vs-metergin 11/20

 /!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

Page 12: Misoprostol vs Metergin

8/16/2019 Misoprostol vs Metergin

http://slidepdf.com/reader/full/misoprostol-vs-metergin 12/20

Result

Page 13: Misoprostol vs Metergin

8/16/2019 Misoprostol vs Metergin

http://slidepdf.com/reader/full/misoprostol-vs-metergin 13/20

Result

Page 14: Misoprostol vs Metergin

8/16/2019 Misoprostol vs Metergin

http://slidepdf.com/reader/full/misoprostol-vs-metergin 14/20

Result

Page 15: Misoprostol vs Metergin

8/16/2019 Misoprostol vs Metergin

http://slidepdf.com/reader/full/misoprostol-vs-metergin 15/20

Result

Page 16: Misoprostol vs Metergin

8/16/2019 Misoprostol vs Metergin

http://slidepdf.com/reader/full/misoprostol-vs-metergin 16/20

Result

Page 17: Misoprostol vs Metergin

8/16/2019 Misoprostol vs Metergin

http://slidepdf.com/reader/full/misoprostol-vs-metergin 17/20

*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

Page 18: Misoprostol vs Metergin

8/16/2019 Misoprostol vs Metergin

http://slidepdf.com/reader/full/misoprostol-vs-metergin 18/20

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 )I@ and)epatitis 0'

Page 19: Misoprostol vs Metergin

8/16/2019 Misoprostol vs Metergin

http://slidepdf.com/reader/full/misoprostol-vs-metergin 19/20

 /!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

Page 20: Misoprostol vs Metergin

8/16/2019 Misoprostol vs Metergin

http://slidepdf.com/reader/full/misoprostol-vs-metergin 20/20

+erimakasih