Introduction: Postpartum hemorrhage (PPH) is a leading cause of maternal morbidity and mortality worldwide. Active management of the third stage of labor (AMTSL) with oxytocin is standard practice, but limitations in storage and administration have prompted evaluation of misoprostol as an adjunct.
Aim:To assess the efficacy of combining intramuscular oxytocin with sublingual misoprostol in reducing postpartum blood loss and minimizing the need for additional uterotonics compared to oxytocin alone.
Methods:A prospective, randomized study was conducted on 100 women delivering vaginally at term. Group 1 (n = 50) received 10 units of intramuscular oxytocin, while Group 2 (n = 50) received oxytocin plus 600 ?g sublingual misoprostol. Demographic variables, hemoglobin levels, blood loss, uterine tone, need for additional uterotonics, and postpartum complications were analyzed.
Results:Mean blood loss was significantly lower in Group 2 (338.3±108.2 ml) compared to Group 1 (426.7±124.6 ml, p = 0.001). The requirement for additional uterotonics was also reduced in Group 2 (18%) versus Group 1 (40%, p = 0.0098). No significant differences were observed in transfusion rates, PPH incidence, or postpartum complications such as shivering and pyrexia.
Conclusion:The addition of sublingual misoprostol to intramuscular oxytocin effectively reduces postpartum blood loss and the need for supplementary uterotonics without increasing adverse outcomes. Combination therapy offers a safe and practical strategy for PPH prevention, particularly in resource-limited settings.
International Journal of Clinical Obstetrics and Gynaecology
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