Prevention of Immediate Postpartum Hemorrhage by The Combination of Oxytocin And Misoprostol at The Gynaecology-Obstetrics Department of The Ignace Deen National Hospital of Conakry University Hospital

Abstract

Abdourahamane DIALLO, Mamadou Hady DIALLO, Almamy Amara TOURE, Ibrahima Tangaly DIALLO, Fatoumata Bamba DIALLO and Telly SY

Objective: This randomised comparative clinical trial aimed to assess the effectiveness and tolerability of combining oxytocin and misoprostol for preventing immediate postpartum haemorrhage (PPH).

Methodology: The study was conducted at the Gynaecology-Obstetrics department of Ignace Deen National Hospital. Participants were randomly assigned to two groups: one receiving oxytocin and placebo and the other receiving oxytocin and misoprostol. Blood loss, incidence of PPH, need for blood transfusion, and adverse effects were measured as primary outcomes.

Results: Analysis of the data revealed that patients receiving oxytocin and misoprostol had significantly lower blood loss (436 ml vs 533 ml, p=0.02) and a notably reduced incidence of PPH compared to those receiving oxytocin and placebo (11.9% vs 38.5%, p=0.00). The need for blood transfusion was also significantly lower in the misoprostol group (9.2% vs. 20.2%, p=0.02). However, the frequency of maternal death was comparable between the two groups (2.7% vs 3.7%, p=0.70). Adverse effects were mainly observed in the misoprostol group, including chills (58.3%), fever (22.9%), and vomiting (12.5%).

Conclusion: Administering 600μg of misoprostol sublingually in addition to the standard 10 IU oxytocin during delivery significantly reduces the incidence of PPH due to uterine atony. This combination therapy demonstrates promising efficacy in preventing postpartum haemorrhage, though close monitoring for potential adverse effects is essential.

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