Management of Third Stage of Labour with Per Rectal Administration of 400 MCG of Tablet Misoprostol Before Delivery of Placenta - Protocol for 3rd Stage of Labour - A Pilot Study

Abstract

Post partum haemorrhage (PPH) is the single most significant and preventable cause of maternal death worldwide. More than half of all maternal deaths occur within 24 hours of delivery, mostly due to excessive bleeding. Aims: The aim of the study was to evaluate the efficiency of tablet misoprostol 400 mcg administered per rectum within one minute of delivery of the baby in preventing postpartum haemorrhage and to study any side effect due to this. Materials and Methods: A prospective pilot study was carried out in a peripheral hospital from 01 Jun 2014 to 10 Oct 2015 110 patients were included in the study. Results: 110 patients of term pregnancy with singleton foetus were evaluated. 24 were primiparas and 86 were multiparas. The mean blood loss of all the patients evaluated was 163.41 ml with SD of 59.97 ml. That of primiparas 163.83 ml with SD of42.78 ml and that of multiparas was 166.93 ml with SD of 63.35 ml. Conclusion: The third stage of labour poses potentially life threatening risks and several severe complications to a mother who has just delivered. The patients in rural and peripheral setups are more vulnerable given their poor nutritional status, rare health care facilities, non availability of trained birth attendants and distance to a tertiary care centre. In larger centres also ,avoidance of post partum haemorrhage adds to maternal well being and saves on hospital resources in terms of man and material. The mean blood loss of 163.41 ml during third stage of labour is an encouraging result especially when no significant side effects were noted.

Keywords

• Postpartum haemorrhage
• Third stage labour
• Misoprostol