EFFECT OF PROPHYLACTIC MISOPROSTOL ON PERIPARTUM CHANGES IN HAEMOGLOBIN CONCENTRATION

Abstract

Objective: To evaluate the effect of prophylactic oral misoprostol on postpartum
haemoglobin concentration values compared to control.
Methodology: The study was a prospective case controlled study. It was carried out at
UNTH and Julius Memorial Hospital, a specialist hospital for women, both in Enugu, Enugu
State, Nigeria, between 1st September and 30th November 2012. The study population was
booked women who did not have any medical condition or obstetric complications. Main
outcome measure was haemoglobin change from the pre-partum value. Secondary outcome
measures were misoprostol side effects and need for blood transfusion.
Results: There was statistical significant difference in the haemoglobin change of the two
groups (P = 0.05). The mean haemoglobin change in the study group was 0.98g/dl ± 0.60 and
in the control group 1.27g/dl ± 0.70, there was statistical significant difference between the
mean haemoglobin change of the 2 groups, (P-value = 0.01). More women in control group
had haemoglobin change greater than the mean value for all parturients that completed the
study. There were no side effects of the test drug in 47% of the study group, 21% of the study
group had shivering, while 21% had pyrexia, 6% of the misoprostol group had weakness, 4%
dizziness and 1% had abdominal cramps. No woman in the control group had the known side
effects of the test drug. Of the 200 women recruited, 169 (84%) completed the study, 7 (4%)
were transfused and 24 (12%) had caesarean section, there was no maternal death.
Conclusion: The augmentation of the routine Active Management of Third Stage of Labour
with 400 micrograms of oral misoprostol was effective in further reducing postpartum blood
loss, thus reducing the need for blood transfusion. The side effects of the drug were tolerable
and largely self-limiting. It is thus recommended to be used prophylactically in preventing
primary postpartum haemorrhage.

EFFECT OF PROPHYLACTIC MISOPROSTOL ON PERIPARTUM CHANGES IN HAEMOGLOBIN CONCENTRATION