A comparative study of efficacy of misoprostol with methyl ergometrine and carboprost in active management of third stage of labour

Supe, Pradnya A.; Kore, Shailesh; Nandanwar, Y. S.

doi:10.18203/2320-1770.ijrcog20161317

Cited by 3 publications

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References 5 publications

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“…Usage of oxytocic agents shown to decrease incidence of postpartum haemorrhage by 40%The use of uterotonic agent may reduce blood loss but often associated with nausea, vomiting, myocardial infarction, intracerebral haemorrhage and increased BP. 9 Misoprostol an effective uterotonic agent which binds selectively to EP2 or EP3 prostonoid receptor administering orally or rectal route to prevent postpartum hemorrhage and helpful in the management of third stage labour. 10 Methergine is a conventional oxytocic used extensively but is associated with unpleasant side effects like hypertension.…”

Section: Introductionmentioning

confidence: 99%

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

Singangutti

2018

Int J Reprod Contracept Obstet Gynecol

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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.

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Section: Introductionmentioning

confidence: 99%

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

Singangutti

2018

Int J Reprod Contracept Obstet Gynecol

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“…The independent variables were the duration of the third stage of labor, blood loss, decreased incidence of postpartum hemorrhage, effects on hematocrit, blood pressure and side effects. [18] shoulder, divided into 4 groups: 1. Group A: 25 mothers given 800 mcg misoprostol rectally.…”

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confidence: 99%

Uterotonic Use in the Active Management of Third Stage of Labor (Amtsl): Systematic Review

Putri

Megasari

2022

PLACENTUM J. Ilmiah Kes. Apl.

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Background: Maternal mortality rate in Indonesia has decreased from 184/100,000 live birth (LB) (2016) to 177/100,000 LB (2017), but this number is still high enough than SDGs target of 70/100,000 LB. The one of direct cause of maternal death is hemorrhage, especially postpartum hemorrhage (PPH). Causes of PPH are uterine atony, laceration of birth canal, resistant placenta and uterine inversion. PPH prevention method is Active Management of Third Stage of Labor (AMTSL). The objective of this systematic review is to analyze the use of uterotonics in AMTSL.Methods: This systematic review used the PRISMA protocol, articles taken from Google Scholar, Science Direct, and Pub Med. The time span of the research article was 2010 to 2021.Result: The results of the study describe that the use of uterotonics in single use or combination in third stage of labor can reduce the risk of PPH and shorten the time of the stage. The side effects were reported in misoprostol and methyl ergometrine than oxytocin. In addition, combination therapy with oxytocin and misoprostol can reduce the length of the third stage and the potential for a decrease in hemoglobin within 24 hours of delivery. In Indonesia, if oxytocin is not available, maternal nipple stimulation is performed as nonpharmacological therapy or ergometrine 0.2 mg is given to patients without complications of high blood pressure.Conclusion: The use of uterotonics is adjusted to its cost-effectiveness, ability to store and refrigerate also the benefits compare to the side effects to the patients.

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Uterotonic agents for preventing postpartum haemorrhage: a network meta-analysis

Gallos

Papadopoulou

Man

et al. 2018

Cochrane Database of Systematic Reviews

129

183

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Background Postpartum haemorrhage (PPH) is the leading cause of maternal mortality worldwide. Prophylactic uterotonic agents can prevent PPH, and are routinely recommended. The current World Health Organization (WHO) recommendation for preventing PPH is 10 IU (international units) of intramuscular or intravenous oxytocin. There are several uterotonic agents for preventing PPH but there is still uncertainty about which agent is most effective with the least side effects. This is an update of a Cochrane Review which was first published in April 2018 and was updated to incorporate results from a recent large WHO trial. Objectives To identify the most effective uterotonic agent(s) to prevent PPH with the least side effects, and generate a ranking according to their effectiveness and side‐effect profile. Search methods We searched the Cochrane Pregnancy and Childbirth’s Trials Register, , the World Health Organization (WHO) International Clinical Trials Registry Platform ( ) (24 May 2018), and reference lists of retrieved studies. Selection criteria All randomised controlled trials or cluster‐randomised trials comparing the effectiveness and side effects of uterotonic agents with other uterotonic agents, placebo or no treatment for preventing PPH were eligible for inclusion. Quasi‐randomised trials were excluded. Randomised trials published only as abstracts were eligible if sufficient information could be retrieved. Data collection and analysis At least three review authors independently assessed trials for inclusion and risk of bias, extracted data and checked them for accuracy. We estimated the relative effects and rankings for preventing PPH ≥ 500 mL and PPH ≥ 1000 mL as primary outcomes. Secondary outcomes included blood loss and related outcomes, morbidity outcomes, maternal well‐being and satisfaction and side effects. Primary outcomes were also reported for pre‐specified subgroups, stratifying by mode of birth, prior risk of PPH, healthcare setting, dosage, regimen and route of administration. We performed pairwise meta‐analyses and network meta‐analysis to determine the relative effects and rankings of all available agents. Main results The network meta‐analysis included 196 trials (135,559 women) involving seven uterotonic agents and placebo or no treatment, conducted across 53 countries (including high‐, middle‐ and low‐income countries). Most trials were performed in a hospital setting (187/196, 95.4%) with women undergoing a vaginal birth (71.5%, 140/196). Relative effects from the network meta‐analysis suggested that all agents were effective for preventing PPH ≥ 500 mL when compared with placebo or no treatment. The three highest ranked uterotonic agents for prevention of PPH ≥ 500 mL were ergometrine plus oxytocin combination, misoprostol plus oxytocin combination and carbetocin. There ...

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A comparative study of efficacy of misoprostol with methyl ergometrine and carboprost in active management of third stage of labour

Cited by 3 publications

References 5 publications

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

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

Uterotonic Use in the Active Management of Third Stage of Labor (Amtsl): Systematic Review

Uterotonic agents for preventing postpartum haemorrhage: a network meta-analysis

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