RECTALLY ADMINISTERED MISOPROSTOL FOR THE TREATMENT OF POSTPARTUM HEMORRHAGE UNRESPONSIVE TO OXYTOCIN AND ERGOMETRINE - A DESCRIPTIVE STUDY

Objective: To investigate whether rectally administered misoprostol is an effective treatment for postpartum hemorrhage unresponsive to conv entional first-line management. Methods: We studied 14 women with post partum hemorrhage unresponsive to oxytocin and ergometrine (n = 10) or , when ergometrine was contraindicated, oxytocin alone (n 4). While aw aiting carboprost, misoprostol 1000 mu g (five tablets) was administer ed rectally. Results: In all 14 women, the hemorrhage was controlled, and sustained uterine contraction produced within three minutes of adm inistration of misoprostol. Conclusion: Misoprostol appears to be abso rbed effectively from rectal as well as oral and vaginal mucosa. Recta lly administered misoprostol appears to be an effective treatment for postpartum hemorrhage unresponsive to oxytocin and ergometrine; theref ore, it might be an alternative to parenteral prostaglandins or at lea st minimize the number of women requiring this invasive treatment. Giv en that it is an inexpensive and stable drug, misoprostol has consider able potential to reduce maternal mortality from postpartum hemorrhage in developing countries. (Obstet Gynecol 1998; 92:212-4. (C) 1998 by The American College of Obstetricians and Gynecologists.)