scholarly journals Use of Oral Misoprostol, Intramuscular Oxytocin and Intravenous Methergin in Prevention of Postpartum Haemorrhage

2013 ◽  
Vol 8 (1) ◽  
pp. 34-36
Author(s):  
Banwari Lal Meena
Keyword(s):  
Blood Transfusion ◽  
Blood Loss ◽  
Post Partum ◽  
Active Management ◽  
P Value ◽  
Multi Centre Study ◽  
Oral Misoprostol ◽  
Third Stage ◽  
Group B ◽  
A Prospective Study

Aims: The purpose of the study was to compare the efficacy of misoporstol 600mg orally (Group A), injection oxytocin 10 IU intramuscularly (Group B) and injection methylergometrine 0.2 mg intravenously (Group C) on reducing blood loss in third stage of labour, duration of third stage of labour, effect on haemoglobin of the patient, need of additional oxytocics or blood transfusion and associated side effects and complications. Methods: A prospective study enrolling 510 women and randomising them into three groups was done in S P Medical College, Bikaner, Rajasthan, India. Active management of third stage of labour was done using one of the three uterotonics as per the group of the patient. Results: Methylergometrine was superior to rest of the drugs with lowest duration of third stage of labour (p = 0.02), lowest amount of blood loss (p = 0.0001) and lowest rate of post partum hemorrhage (p = 0.08). The need of additional oxytocics and blood transfusion was highest with oral misoprostol as compared to all other drugs used in the study with p value of 0.08 and 0.009 respectively. Conclusions: Methylergometrine has the best uterotonic drug profile amongst the drugs used, strongly favouring its routine use as oxytocic for active management of third stage of labour. Oral misoprostol resulted in a higher blood loss compared to other drugs and hence it should be used only in low-resource settings where other drugs are not available. However, a large multi-centre study is needed for the confirmation of the finding. Nepal Journal of Obstetrics and Gynaecology / Vol 8 / No. 1 / Issue 15 / Jan- June, 2013 / 34-36 DOI: http://dx.doi.org/10.3126/njog.v8i1.8859

scholarly journals Comparison of Oral Misoprostol with Intramuscular Oxytocin in the Active Management of Third Stage of Labour

2015 ◽  
Vol 10 (1) ◽  
pp. 76-80
Author(s):  
S Kaudel ◽  
A Rana ◽  
N Ojha
Keyword(s):  
Blood Transfusion ◽  
Post Partum ◽  
University Teaching ◽  
Active Management ◽  
The Third ◽  
Oral Misoprostol ◽  
Third Stage ◽  
Group A ◽  
Prospective Comparative Study ◽  
Group B

Aims: This study aimed at comparing the efficacy of oral misoprostol 600 mcg with intramuscular oxytocin 10 IU in the active management of third stage of labour. Methods: This prospective comparative study was performed in Tribhuvan University Teaching Hospital to compare the efficacy of oral misoprostol with intramuscular oxytocin in the third stage of labour for the prevention of postpartum hemorrhage. One hundred and twenty women without risk of PPH were randomly allocated to receive either 600 mcg misoprostol orally (Group A) or 10 unit of oxytocin intramuscularly (Group B) within 1 minute of delivery. The efficacy and the safety of these two drugs were analyzed on the basis of percentages fall in hemoglobin (Hb) and hematocrit (Hct) level from before delivery to 8 completed hours after delivery, need for additional uterotonic agents, need for exploration and uterine evacuation, need for blood transfusion, duration of third stage of labour and the numbers of retained placenta and need for MRP. Results: Oral misoprostol was observed to be equally effective as intramuscular oxytocin in prevention of post-partum hemorrhage (PPH). There was no statistical difference in the duration of third stage of labour, need for additional uterotonics, need for uterine exploration/evacuation and need for blood transfusion in the two groups. Conclusions: Routine use of oral misoprostol 600 mcg appears to be as effective as 10 IU intramuscular oxytocin in minimizing blood loss during the third stage of labour.

scholarly journals Third stage of labour: expectant versus active management-a comparative study in local low risk population

2019 ◽  
Vol 8 (2) ◽  
pp. 641
Author(s):  
Kavita A. Chandnani ◽  
Deepti D. Sharma
Keyword(s):  
Blood Loss ◽  
Comparative Study ◽  
Maternal Mortality ◽  
Post Partum ◽  
Expectant Management ◽  
Active Management ◽  
Research Centre ◽  
Third Stage ◽  
Group A ◽  
Group B

Background: Postpartum haemorrhage (PPH) is the leading cause of maternal mortality, accounting for about 35% of all maternal deaths. These deaths have a major impact on the lives and health of the families affected. Thus, anticipation as well as proper management of 3rd stage of labour is mandatory. The objective of this study was to compare expectant and active management of third stage of labour in preventing post-partum blood loss and having impact on prevention of maternal mortality in local population. Advantages and disadvantages of both techniques might be over estimated.Methods: Prospective comparative study carried out in Obstetrics and Gynecology department of SBKSMIRC (Shrimati Bhikhiben Kanjibhai Shah Medical Institute and Research Centre), Dhiraj general hospital, comprising of 200 laboring women admitted directly or from OPD to labour room for expected vaginal delivery. They were randomly allocated to group A (expectant management) and group B (active management). Labour progress was charted on partograph and interventions recorded. Statistical analysis of data was done after compiling and tabulation of data. Mean±SD for descriptive variables were calculated and appropriate statistical tests applied to determine significance.Results: Average PPBL (post-partum blood loss) was 360.5ml in group A as compared to 290.6ml in group B. 12 patients in group A had blood loss more than 500ml while none in group B. 66% cases in group B had duration of third stage of labour less than 5 min as compared to only 22% in group A. the mean duration of third stage was 13.46±8.3 in group A while 5.32±3.05 in group B. these differences were statistically significant.Conclusions: Active management of the third stage of labour is associated with less blood loss as well as a shorter duration of third stage compared with expectant management. It is reasonable to advocate this regime.

scholarly journals Study of effect of intra-umbilical oxytocin along with active management in third stage of labor

2021 ◽  
Vol 10 (9) ◽  
pp. 3486
Author(s):  
Neetu Verma ◽  
Monica Soni ◽  
Priyanka Singh
Keyword(s):  
Blood Loss ◽  
Normal Saline ◽  
Demographic Data ◽  
Active Management ◽  
P Value ◽  
Study Group ◽  
Third Stage Of Labor ◽  
Third Stage ◽  
Group A ◽  
Group B

Background: The aim of the study was to determine effect of intra-umbilical oxytocin along with active management on duration and amount of blood loss in 3rd of stage of labor.Methods: This was a hospital based prospective, randomized, case-control study conducted in the department of OBG between 1st September 2019 to 31st December 2020. After obtaining permission from ethical committee, screening of inclusion and exclusion criteria and informed consent of participants, 300 cases were enrolled. In group A (control) 20 ml normal saline and in group B (case) 20 IU oxytocin diluted in normal saline to make a 20 ml solution was given intra-umbilically along with standard active management of third stage labor. The data was systematically recorded and analysed.Results: Both the groups were comparable in terms of demographic data.  A statistically significant reduction in the duration of third stage of  labor (1.83±0.64  min in group B vs 2.92±0.79 min in group A), amount of blood loss (203.73±62.11 ml in group B vs 328.83±87.18 ml  group A) and fall in haemoglobin (9.28±1.03 g/dl in the study group A vs 9.97±1.28 g/dl in group B) and haematocrit (31.20±3.05% in  study group A vs 33.60±3.31%  in study group B)  were noted, taking p value  significant <0.05.Conclusions: Intra-umbilical oxytocin was associated with a significant reduction in duration and amount blood loss in third stage of labor.

scholarly journals Intramuscular oxytocin 10 units versus intravenous methylergometrine 0.2 mg in active management of third stage of labour for prevention of postpartum haemorrhage: a comparative study

2020 ◽  
Vol 9 (2) ◽  
pp. 494
Author(s):  
Divya Narayana ◽  
B. Pathak ◽  
Abha Khurana ◽  
Uttara Aiyer Kohli
Keyword(s):  
Side Effects ◽  
Blood Transfusion ◽  
Blood Loss ◽  
Post Partum ◽  
Tertiary Care ◽  
Active Management ◽  
Normal Delivery ◽  
Post Partum Hemorrhage ◽  
The Third ◽  
Third Stage

Background: To compare the effectiveness of 10 IU of oxytocin IM with 0.2 mg methyl ergometrine IV in the prevention of post-partum hemorrhage when used as a part of active management of third stage of labour. This study aims to compare their influence on duration of the third stage of labour, the amount of blood loss during the third stage of labour and the immediate post-partum period and side effects of the drugs if any.Methods: The study was conducted in a tertiary care teaching hospital. 200 women, who underwent normal delivery with or without episiotomy, were enrolled and were randomly distributed into two groups. 100 women received 10 IU of intramuscular Oxytocin and 100 women received intravenous 0.2 mg of methyl ergometrine. Women of both the groups were given the medication after delivery of anterior shoulder of the baby. Comparison done between percentages fall in Hb from before delivery to 24 hours after delivery, need for additional uterotonic agents, need for blood transfusion, duration of third stage of labour and any side effects including retained placenta and need for manual removal of placenta.Results: Intravenous methylergometrine was observed to be equally effective as intramuscular oxytocin in prevention of post-partum hemorrhage. There was no difference in the duration of third stage of labour, amount of blood loss, need for additional uterotonic agents, and need for blood transfusion in both the groups. There was no significant side effect in both the groups.Conclusions: Intramuscular oxytocin is as efficacious as Intravenous methylergometrine in the prevention of postpartum hemorrhage with no side effects.

scholarly journals Active management of third stage of labour: comparison between prophylactic intramuscular methylergometrine and intramuscular oxytocin

1970 ◽  
Vol 2 (2) ◽  
pp. 24-28 ◽  
Author(s):  
Shilu Adhikari ◽  
Ashma Rana ◽  
Kesang D Bista
Keyword(s):  
Side Effects ◽  
Blood Transfusion ◽  
Blood Loss ◽  
Postpartum Hemorrhage ◽  
Post Partum ◽  
Statistical Significance ◽  
Active Management ◽  
Normal Vaginal Delivery ◽  
The Third ◽  
Third Stage

Aim: Aimed at comparing the efficacy of prophylactic intramuscular methylergometrine with intramuscular oxytocin in reducing blood loss in the third stage of labour (TSL). Methods: This is a randomized, comparative, clinical trial to compare the efficacy of intramuscular methylergometrine with intramuscular oxytocin in the third stage of labour for the prevention of postpartum hemorrhage Two hundred women undergoing normal vaginal delivery were recruited, 100 in each group- Group A receiving .2mg methylergometrine intramuscularly and Group B receiving 10U oxytocin intramuscularly immediately after the delivery of the anterior shoulder of the baby. The efficacy and the safety of these two drugs were analyzed on the basis of percentages fall in haemoglobin (Hb) and haematocrit (Hct) level from before delivery to 24 completed hours after delivery, need for additional uterotonic agents, need for exploration and uterine evacuation, need for blood transfusion, duration of third stage of labour and the numbers of retained placenta and need for MRP. Results: Intramuscular methylergometrine was observed to be equally effective as intramuscular oxytocin in prevention of post partum haemorrhage (PPH) [defined as fall in Hb and /or Hct level³ 10% from before delivery to 24 hours after delivery]. There was no difference in the risk of prolonged third stage, need for additional uterotonic agents, need for exploration and uterine evacuation and need for blood transfusion in the two groups. The side effects were all mild in nature and the overall incidence was too low for statistical significance to be elicited. Conclusion: Intramuscular methylergometrine is as efficacious as intramuscular oxytocin in the prevention of third stage blood loss with comparable side effects. Keywords: Third stage of labour, postpartum hemorrhage, methylergometrine, oxytocin.   doi:10.3126/njog.v2i2.1451   N. J. Obstet. Gynaecol 2007 Nov-Dec; 2 (2): 24 - 28

scholarly journals A comparative study between intramuscular oxytocin and intramuscular methyl ergometrine in the active management of third stage of labour

2018 ◽  
Vol 7 (5) ◽  
pp. 1943 ◽  
Author(s):  
Devi Reddy Hema Swapnika ◽  
Prema Priya G. ◽  
S. Senthil Priya ◽  
A. S. Allirathinam
Keyword(s):  
Side Effects ◽  
Blood Transfusion ◽  
Blood Loss ◽  
Active Management ◽  
P Value ◽  
Singleton Pregnancy ◽  
The Third ◽  
Third Stage ◽  
The Difference ◽  
Vertex Presentation

Background: To compare the efficacy of prophylactic IM oxytocin 10U and IM methyl ergometrine 0.2mg on duration of third stage of labour, amount of blood loss during the third stage of labour and associated side effects.Methods: 50 low risk antenatal women with singleton pregnancy at term gestation in vertex presentation admitted for vaginal delivery, were randomly allocated into 2groups of 25 each and managed actively in the third stage of labour either with 10 U oxytocin IM or with 0.2mg methyl ergometrine IM immediately after the birth of the baby. The main outcome measures were the difference between the 2groups with regard to: duration of third stage of labour, blood loss by volume, difference in haemoglobin and haematocrit, need for blood transfusion, additional uterotonics and side effects of drugs.Results: The mean duration of third stage of labour in the oxytocin group was 6.68±2.17min and in methergine group was 6.4±1.93 min. Mean blood loss was 302±75.6ml and 282.8±58.27ml. Mean fall in Hb was 0.92gm% and 0.812gm%. Mean fall in PCV was 2.36% and 1.88%. 2women in oxytocin group and 1woman in methergine group received additional 0.2mg methergine. 3women in both groups received 1unit of blood transfusion. 8women who received methergine had side effects while only one in the oxytocin group, with a p value 0.004 which is statistically significant.Conclusions: This study has shown that both oxytocin and methylergometrine were equally efficacious. However, oxytocin had significantly better safety profile and lesser contraindications for usage.

scholarly journals A prospective randomized controlled trial for comparison of oral misoprostol with methyl ergometrine in the third stage of labour for prevention of post-partum haemorrhage

2017 ◽  
Vol 6 (7) ◽  
pp. 2825 ◽  
Author(s):  
Sushma Gore ◽  
Atul Padmawar ◽  
Sabir Khan Pathan
Keyword(s):  
Post Partum ◽  
Tertiary Care ◽  
Active Management ◽  
Oral Misoprostol ◽  
Vaginal Deliveries ◽  
Third Stage ◽  
Group A ◽  
Post Partum Haemorrhage ◽  
Group B ◽  
Study Participants

Background: Near about 11% of women having live births have severe PPH (Globally 14 million women per year). About 3.9% of vaginal deliveries and 6.4% of cesarean section get PPH. Near about 1.4 million women die of PPH every year. Frequency of PPH is related to management of third stage of labour. Objective of the study was to compare the efficacy of misoprostol with conventional oxytocics for active management of third stage of labour.Methods: The present study was carried out in tertiary care teaching hospital for a period of three years from June 2007-May 2010. A total of 364 study participants who reported to labour ward with labour pains in latent phase and subsequently went in spontaneous labour were enrolled and randomly distributed to two groups and given oral misoprostol and i.v. ergometrine.Results: The mean age in Group A was 23.17±2.55 and 24.31±3.28 respectively. It was observed that most the study participants in both the groups had the duration of third stage of labour in between 10-14 minutes i.e. 29% in Group A and 36.3% in Group B respectively. The duration of third stage of labour was significantly more in Group B compared to Group A.Conclusions: Misoprostol is a promising drug in the management of third stage of labour for the prevention of post- partum haemorrhage.

scholarly journals Active management of third stage of labor

1970 ◽  
Vol 1 (2) ◽  
pp. 25-27
Author(s):  
Meena Thapa ◽  
Rachana Saha ◽  
Sumita Pradhan ◽  
Sushil Thakur ◽  
Archan Shamsher Rana
Keyword(s):  
Blood Loss ◽  
Post Partum ◽  
College Teaching ◽  
Uterine Atony ◽  
Active Management ◽  
Retained Placenta ◽  
Average Blood Loss ◽  
Cord Clamping ◽  
Third Stage Of Labor ◽  
Third Stage

Objective: Overall objective of the study was to see effects of active management of third stage of labour (AMSTL) with oxytocin. Specific objective of the study was to look for incidence of Post-Partum Haemorrhage (PPH), length of 3rd stage, incidence of retained placenta and average blood loss. Methodology: A hospital based prospective, descriptive, observational study was carried out from 1st July 2005 to 30th June 2006 at department of Obstetrics and Gynaecology, Kathmandu Medical College Teaching Hospital (KMCTH). All patients undergoing vaginal delivery excluding twins, polyhydraminios and instrumental deliveries were included in the study. The active management of 3rd stage included administration of 10 units IU of oxytocin, early cord clamping, controlled cord traction and uterine massage. Blood loss was estimated by visual inspection and measured by jar pressed against perineum. Result: Total number of deliveries during the study period was 530. There were 13 cases of PPH. Incidence of PPH was 2.4%. There were six cases each of uterine atony and genital tract trauma. One case was of retained placenta requiring Manual Removal (MRP). Average third stage duration was less than 5 minutes. Average blood loss was 90 ml. In 2 cases the third stage lasted more than 30 mins. Conclusion: Active management of 3rd stage of labour reduces the incidence of PPH from uterine atony, reduces the duration as well as average blood loss during third stage.condition. Key words: Labor analgesia; epidural, combined spinal epidural; complications, dural puncture, postdural puncture headache (PDPH); prevention.   doi:10.3126/njog.v1i2.1490 N. J. Obstet. Gynaecol Vol. 1, No. 2, p. 25 - 27 Nov-Dec 2006

scholarly journals A Comparative Study of Active Management of the Third Stage of Labor IV Methergine and IM Oxytocin

2021 ◽  
pp. 267-272
Author(s):  
K. Sharmila
Keyword(s):  
Blood Loss ◽  
The United States ◽  
Active Management ◽  
P Value ◽  
Negative Effects ◽  
The Third ◽  
Third Stage Of Labor ◽  
Group I ◽  
Third Stage ◽  
The Mean

Postpartum haemorrhage (PPH) has been more common over the last three decades, accounting for 11% of all pregnancy-related deaths in the United States. In the third stage of labour, risk classification and active management are crucial preventative techniques. To avoid negative effects, a multidisciplinary approach to PPH patient care is required. To treat uterine atony, uterotonic medicines like oxytocin are used in combination with manipulative procedures like uterine massage and balloon tamponade. The amount of blood loss, duration of the third stage, need for MRP, incidence of PPH, need for repeated oxytocics, and its side effects were measured in Group I 100 women who were administered injection oxytocin 10 IU injection methergin 0.2 mg IV within one minute of the baby's delivery. The mean blood loss at vaginal delivery in Group I was 100-150 ml and in group I P value 0.027, which was statistically significant .In  Group II was 160-200 ml with P value 0.036, which was statistically significant. The mean duration of third stag labour in Group 1 was 124.6 min and Group 2 was 144.8 min intravenous methergin is a better uterotonic when compared to intramuscular oxytocin to reduce the amount of blood loss at delivery and prevent complications like atonic PPH.

scholarly journals A Comparative Study of Oxytocin & Misoprostol in Active Management of Third Stage of Labour

2015 ◽  
Vol 12 (1) ◽  
pp. 22-24
Author(s):  
N Ansari ◽  
CR Das
Keyword(s):  
Blood Loss ◽  
College Teaching ◽  
Cross Sectional Study ◽  
Active Management ◽  
Cross Sectional ◽  
Medical College ◽  
Significant Difference ◽  
Third Stage ◽  
Group A ◽  
Group B

Introduction: The third stage of labour is the period which follows the completed delivery of the foetus and consists of delivery of the placenta and its attached membranes.Aims and objectives: Comparison of oxytocin & misoprostol in active management of third stage of labour.Material and Methods: This is a comparative cross-sectional study was conducted in Nepalgunj Medical College Teaching Hospital, Kohalpur from March 2013 to March 2014. Group A - Oxytocin 10 IU IV bolus in 100 patients and Group B - Misoprostol 600 micro gram rectally. The collected were subjected to statistical analysis using SPSS 15.Results: After active management with bolus oxytocin, the blood loss was grossly reduced being 40-100ml in 84% cases and only 7% had blood loss more than 100ml. blood loss between 200-300ml were only 6% and only 3% had PPH, after misoprostol 80% of cases had blood loss within 40 – 100 ml., 6% cases had blood loss within 100 – 200 ml. and larger amount of blood loss i.e. between 200 – 300 ml. was observed in 7% cases, in 3% cases blood loss was between 300 – 400 ml. and 4% of women in this group had PPH.Conclusion: There was no statistically significant difference in the efficacy of oxytocin and misoprostol in reducing amount of blood loss and duration of labour rd in 3 stage of labour.Journal of Nepalgunj Medical College Vol.12(1) 2014: 22-24

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