الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 48 |  |  |
| | | from | 48 | | |
Abstract
Third stage of labor is a critical stage for the management and prevention of postpartum hemorrhage and is defined as the period between the delivery of baby and placenta. The most common causes of postpartum hemorrhage uterine atony, genital tract trauma during delivery, coagulopathy and placental abnormalities.In active management of third stage of labor we enhance the separation and delivery of placenta by increasing uterine contractions to control the blood loss and decreasing the risk of postpartum hemorrhage. Active management of third stage of normal labour include administration of utrotonic medications after delivery of the baby, early clamping and cutting the umbilical cord and controlled traction of umbilical cord while separation and delivery of the placenta. Utrotonic medications are Oxytocin, ergot alkaloids, Syntometrien and Misoprostol. Misoprostol is a prostaglandin E1 analogue and it is one of the cheapest prostaglandin, easy used and stored. Misoprostol is available as tablet that can be administered by oral, sublingual, rectal or vaginal route. It is stable at room temperature and inexpensive. The use of misoprostol is proliferating around the world. It is a life saving treatment for severe postpartum hemorrhage and it is also used to reduce blood loss during labor. It is also used in induction of labor and induction of abortion. Also it has other non obstetric use as it is used in the treatment of peptic ulcer.The aim of this study is to compare the efficacy of IV ergometrine, rectal misopristol and sublingual misopristol in the active management of 3rd stage of labor. The same protocol was applied in Al-Jomhoria hospital - Garunis University – Benghazi - Libya as double blind multi-center study.In our study we compared the efficacy of sublingual misoprostol versus rectal misopristol and IV ergometrin in active management of third stage as uterotonic drug and inspected its effect on reducing blood loss and its side effects. 150 primigravida in Alexandria University Shatby maternity hospital who had undergo normal vaginal delivery and were divided in 3 groups according to the drug used in management of the 3rd stage of labor as group I include 50 primigravida were actively management of the 3rd stage of labor by one ampoule of ergometrin IV after delivery of anterior shoulder of the baby. While group II include 50 primigravida were actively management of the 3rd stage of labor by one rectal tablet of misopristol after delivery of anterior shoulder of the baby. And lastly group III include 50 primigravida were actively management of the 3rd stage of labor by one sublingual tablet of misopristol after delivery of anterior shoulder of the baby. All patients were closely observed for time of placental delivery, amount of blood loss by Hb and heamatocrit value pre and immediately post delivery (within 1 hour), use of oxytocin and any recorded side effects.