Role of Intaumbilical Misoprostol in Prevention of Postpartum Hemorrhage
Kerbala Journal of Medicine,
2010, Volume 3, Issue 6, Pages 840-849
AbstractBackground: Prostaglandins have mainly been used for postpartum hemorrhage
(pph) when other measures fail,misoprostol, a new and inexpensive prostaglandin E1
analougue,has been suggested as an alternative for routine management of he third
stage of labour.
Aim o the study: To determine the efficacy of intraumbilical oxytocin administration
compared with intraumbilical misoprostol administration for prevention of postpartum
Materials and methods: Prospective study done at Babylon Hospital for Maternity
and Pediatrics from February 2009 to September 2009.
study involved 75 women in their 3rd. stage of labor subdivided into 3 groups 25 for
each received either 30 i.u oxytocin in 30 ml saline or 800 mcg of misoprostol
dissolved in 30 ml of saline 3rd group was control received only 30 ml of saline
injected into the placental bed via umbilical vein using pipingas technique .
The primary outcome measured was duration of 3rd stage of labor , amount of blood
loss and need for manual removal of placenta. P-value of <0.01 considered
Results: All groups are comparable in their demographic criteria. Intraumbilical
injection of misoprostol associated with shorter duration of 3rd stage of labor (2.5 ±
0.2 min) compared with oxytocin group (3.5 ± 1.1 min) and control group (5.56 ± 2.2
min) p value <0.0001. Blood loss was comparable in both misoprostol and oxytocin
group (31.6± 15 ml and 33.2±18.7 ml respectively, p-value >0.05) which was
significantly lower than control group (147.1 ± 99 ml) p value <0.0001. No reported
cases of retained placenta in both oxytocin and misoprostol groups compared with 2
cases (8%) in control group. Further uterotonic drugs required in 20% of control
group. No significant side effects reported in all study groups.
1- Intaumbilical injection of 800 mcg misoprostol dissolved in 30 ml of saline using
pipingas technique was more effective than intraumbilical oxytocin in shortening the
duration of 3rd stage of labor and both reduce the incidence of postpartum
2- the intraumbilical injection of uterotonics is non- invasive ,effective and clinically
safe method for management of 3rd stage of labor and prevention of postpartum
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