FREQUENCY OF PPH AFTER ADMINISTRATION OF MISOPROSTOL IN FEMALES UNDERGOING NORMAL VAGINAL DELIVERY

Abstract

Abstract

Post-partum hemorrhage (PPH) can be noted as the condition when there is a loss of greater than 500 ml of blood following vaginal birth or of greater than 1000 ml in caesarian section. Those effected by PPH need elaborate measures to restore and maintain the circula-tion of blood, and thus, the perfusion pressures in criti-cal structures. There are situations during PPH that lead to extensive surgery and are continuing bleeding secondary to a uterus being atonic and unresponsive, being ruptured, or having a large cervical laceration. Many drugs are available for the management of PPH but only few are present that prevent PPH to begin with. So we conducted this study to prevent PPH in females going through routine vaginal delivery in order to implement this in the procedures and ensure that excessive blood loss, along with other terrible outcomes of PPH, are not reached.

Objective:  To determine the frequency of PPH after administration of Misoprostol in females undergoing normal vaginal delivery.

Materials and Methods:  This descriptive case series study was carried out in Unit IV, Department of Obs-tetrics and Gynaecology, Lady Aitchison Hospital, Lahore. The non-probability purposive sampling tech-nique was used for this study. After approval from the ethical committee, 220 high risk patients, who fulfilled the inclusion criteria, were selected. Informed consent was obtained and patient demographic information (name, age, gestational age, contact) will be recorded. Labour was monitored by the oxytocin and delivery
of placenta was by the controlled cord traction. Then 600μg of misoprostol was placed per rectal by resear-cher herself and the patient was monitored ½ hourly for blood loss within the next 24 hours. PPH was labe-led as per operational definition. Females, who develo-ped PPH, were managed as per hospital protocol. Data was entered and analysed as per SPSS qualitative vari-able like parity and PPH were presented as frequency and percentage.

Results:  In the aforementioned research, the average age of the subjects was 29.89 ± 5.88 years with mean gestational age of 38.86 ± 1.38 weeks the mean blood loss was 374 ± 134.92 ml. PPH occurred in 35.45% of patients. Statistically, there was a drastic difference between the PPH of the patients and the blood loss i.e. p-value = 0.000.

Conclusion:  The frequency of PPH after adminis-tration if misoprostols in females undergoing normal vaginal delivery was low and less blood loss was observed.

Keywords:  Postpartum hemorrhage, PPH, misopro-stol, pregnant females, normal vaginal delivery, NVD.