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Abstract
STUDY THE EFFICACY OF INTRAUTERINE MISOPROSTOL DURING CESAREAN SECTION WITH OXYTOCIN IN PREVENTION OF PRIMARY PPH
Walaa Salamh*, Louai Hasan and Lina Ramadan
ABSTRACT
Background: postpartum hemorrhage is one of the most common obstetric maternal complication and is among the three most common etiologies of maternal death worldwide. Objective: to compare the incidence of postpartum hemorrhage in women eligible for elective cesarean section (cs) delivery when using intrauterine misoprostol added to oxytocin versus oxytocin alone. Materials and Methods: This parallel randomized trial study was conducted in the Department of Obstetrics and Gynecology at Tishreen University Hospital, Latakia, during the period between March 2022- March 2023. 200women eligible for elective Delivery were enrolled in the study Before randomization all women received the same preparation after randomization in the study group(100)intrauterine misoprostol was used after placental delivery with oxytocin in the control study (100)the routine oxytocin alone was used Results: the case group included(100)pregnant women (mean age 28,2 ±3.3 years mean gestational age38.8±0.6) and control group included (100)pregnant women (mean age27.9±2.8 ,mean gestational age 38.6±0.8). the difference between the two groups was not statistically significant for each of the pregnant woman age gestational age obstetric history ;pregnancy circumstance Intrauterine misoprostol combined with oxytocin intravenous significantly reduced the estimated intraoperative blood loss, the total blood loss within 24hours postoperative when compared with oxytocin intravenous only the difference was statistically significant Misoprostol use was also associated with increased incidence of nausea vomiting (8% versus 6%), fever (4% versus 1%), shivering (3% versus 1%) decrease incidence of headache (2% versus 4%) but the difference was not statistically significant Conclusion: intrauterine misoprostol (400mg)when added to oxytocin is safe and effective in decreasing the incidence of postpartum hemorrhage(pph)and reducing the amount of postpartum blood loss in case of elective Delivery.
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