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Objective.-To evaluate a post -partum hemorrhage treatment guideline,using rectall y administered misopros-tol.Patients and methods.-A descriptive study was carried out in a tertiary referral center from January 2002to March 2003.During this period,2670patients delivered and 41(1.5%)with severe postpartum hemorrhage u nre-sponsive to oxytocin received 1000μg of misoprostol(five tablets)rectally while awaiting sulproston e.Twenty -eight had delivered by the vaginal route an d 13by cesarean section.Results.-Hemorrhage was c ontrolled among63%(26/41)of the patients within 10min of the ad-ministration of rectal misoprostol.Fifteen(37%)patients received both misoprostol and sulpr ostone and no major adverse effects were noted when comb ining these two prostaglandins.Overall,hemorrhage was controlled among87%(36/41)of the patients when oxytocics were c om-bined with misoprostol and sulprostone.Five patients(12%)did not respond to the combination of uterotonicsand required a conservative surgica l treatment.Discussion and conclusion.-Rectal misoprosto l may be an effective second line treatment for the manage ment of post -partum hemorrhage unresponsive to oxytocin.We did not observe major side effects when combining mi soprostol with sul-prostone.Our findings encourage fu rther research on rectal misoprostol in the treatment of postpartum hemorrhage.
Objective-To To evaluate a post-partum hemorrhage treatment guideline, using rectall y administered misopros-tol. Patients and methods. -A descriptive study was carried out in a tertiary referral center from January 2002 to March 2003. This this period, 2670patients delivered 41 (1.5%) with severe postpartum hemorrhage u nre-sponsive to oxytocin received 1000 μg of misoprostol (five tablets) rectally while awaiting sulproston e.Twenty-discharged had delivered by the vaginal route an d 13by cesarean section. Results-Hemorrhage was c Ontrolled among63% (26/41) of the patients within 10 min of the ad-ministration of rectal misoprostol. Fifteen (37%) patients received both misoprostol and sulprostone and no major adverse effects were noted when comb ining these two prostaglandins. hemorrhage was controlled among87% (36/41) of the patients when oxytocics were c om-bined with misoprostol and sulprostone .Five patients (12%) did not respond to the combination of uterotonicsand required a conservative sur gica l treatment. Disacssion and conclusion. -Rectal misoprosto l may be an effective second line treatment for the management of post-partum hemorrhage unresponsive to oxytocin. We did not observe major side effects when combining mi soprostol with sul-prostone. Our findings encourage further research on rectal misoprostol in the treatment of postpartum hemorrhage.