title: Effectiveness of Per Rectal Misoprostol Versus Intramuscular Oxytocin for Prevention of Primary Postpartum Haemorrhage.
abstract: OBJECTIVE
  To compare the effectiveness of per rectal misoprostol over oxytocin in primary postpartum haemorrhage (PPH).
  
  
  METHODS
  Randomised controlled trial study.
  
  
  METHODS
  Gynaecology and Obstetrics Department, Unit IV, Bolan Medical Complex Hospital, Quetta, from September 2013 to February 2014.
  
  
  METHODS
  Emergency obstetric patients receiving per rectal misoprostol (800 µgm) were named as group 'A' and those receiving 10 units oxytocin intramuscularly were labelled as group 'B'. The patients were followed within 24 hours of spontaneous vaginal deliveries. Pads soaked were used to assess the amount of blood loss.
  
  
  RESULTS
  A total of 1,678 patients were included in the study. The mean age of patients in group-A was 29.11 years while the mean age of patients in group-B was 29.16 years. One hundred and twenty-three (14.66%) patients in group-A and 120 (14.31%) patients in group-B had PPH. Among the total 1,678 patients, 243 (14.49%) had postpartum haemorrhage among whom 24 (9.88%) had major haemorrhage with a blood loss ≥1000 mL. Among the sub-group (839 patients) administered misoprostol had 123 (14.66%) patients with blood loss greater than 500 mL and the rest 716 patients (85.34%) had blood loss less than 500 mL. The sub-group administered oxytocin have 120 (14.31%) out of 839 patients with postpartum haemorrhage while 719 (85.69%) had blood loss less than 500 mL.
  
  
  CONCLUSIONS
  Active management of 3rd stage of labour with per rectal misoprostol administration was as effective as intramuscular oxytocin. Both were equally effective to reduce PPH and the subsequent need for surgical interventions.
authors.affiliation: Department of Gynaecology and Obstetrics, Bolan Medical Complex Hospital, Quetta.
authors.forename: Raheela
authors.initials: R
authors.lastname: Asmat
authors.affiliation: Department of Gynaecology and Obstetrics, Bolan Medical Complex Hospital, Quetta.
authors.forename: Tasneem
authors.initials: T
authors.lastname: Ashraf
authors.affiliation: Department of Gynaecology and Obstetrics, Bolan Medical Complex Hospital, Quetta.
authors.forename: Fazila
authors.initials: F
authors.lastname: Asmat
authors.affiliation: Department of Paediatrics, Bolan Medical Complex Hospital, Quetta.
authors.forename: Shakila
authors.initials: S
authors.lastname: Asmat
authors.affiliation: Department of Oncology, Bolan Medical Complex Hospital, Quetta.
authors.forename: Nagina
authors.initials: N
authors.lastname: Asmat
mesh_terms: D000285:Administration, Rectal; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007273:Injections, Intramuscular; D016595:Misoprostol / Q000008:administration & dosage*; D010121:Oxytocin / Q000008:administration & dosage*; D006473:Postpartum Hemorrhage / Q000188:drug therapy* / Q000401:mortality / Q000517:prevention & control*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011446:Prospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D016595:Misoprostol; D010121:Oxytocin