Intramuscular methergine versus per-rectal misoprostol for prevention of atonic post-partum haemorrhage

Abstract

Background: Postpartum haemorrhage (PPH), is a major hazard of maternal death which is accounting for 30% of deliveries with a 1% mortality rate globally. Present study was designed to compare the efficacy of per rectal misoprostol and intramuscular methergine in the management of 3rd stage labour for prevention of postpartum haemorrhage.Methods: A total four hundred cases with low risk term pregnancy admitted and attending department of obstetrics and gynaecology were considered and were divided in 2 groups such as group 1 consists of 200 patients administered with misoprostol 600µg after delivery and group 2 consists 200 patients administered with methyl ergometrine 0.2mg (intramuscular) after delivery.Results: Methyl ergometrine group had a significant reduction in duration of third stage (p<0.05) and blood loss (p<0.05) when compared to misoprostol group. Need for additional Oxytocics was also more in misoprostol group (8%) as compared to methyl ergometrine group (4%). In group 1 average blood loss was found to be 241.3ml, whereas in group 2 it was 179.3ml. Average Hb levels were significantly reduced in group 2 when compared to group 1 patients. Incidence of side effects like nausea, vomiting is more in methergine group than misoprostol group.Conclusions: Intramuscular methergine results in lower blood loss, reduction in duration of third stage of labour, significantly reduction in hemoglobin level after delivery but is associated with more side effects while per rectal misoprostol is less effective but safe with lesser side effects.