Management of Postpartum Hemorrhage with Misoprostol

pnfwh-us-aid-logoEach year in Pakistan more than 15,000 women die due to pregnancy related complications, among which Postpartum Hemorrhage (PPH) i.e blood loss exceeding 500ml at vaginal delivery and 1000ml at caesarean section is accounting for first leading cause of maternal death in our country.
Primary PPH is usually due to uterine atony which is failure of the uterus to contract and retract which can be prevented by taking some necessary steps. PPH in Pakistan is accounting for about 30% of all maternal death as almost every second women in Pakistan is anemic and small blood loss during labour prone her towards death. So management of PPH is essential to produce a visible dent in current high maternal mortality rate.
On the basis of various scientific researches approved that the incidence of PPH may avoided or prevent up to more than 60% with the effective usage of urotonic medicines like Misoprostol.
Misoprostol is a potent uterotonic medicine that helps to reduce the incidence of post-partum hemorrhage. PPH effectively be controlled if its administrated according to WHO protocol (single dose of 400 to 600 micrograms) is given either sublingual or orally or per rectal immediately after delivery of the baby. Its demonstrated effectiveness in the prevention of post-partum hemorrhage is further enhanced by the fact that it is in-expensive, easily available and convenient to use at community level by any health care provider including Doctors, Midwives, Lady Health Visitors and Lady Health Workers.
Pakistan National Forum on Women’s Health in collaboration with Small Grant Ambassador Fund Program (SGAFP) is initiating an intervention of training of health care providers on Management of PPH with Misoprostol in 8 selected districts of Sindh (Thatta, Badin, Tharparkar, Umerkot, Sanghar, Mirpurkhas, Jamshoro and Karachi) and 5 selected districts of Balochistan (Gwader, Turbat, Loralai, Sibi and Quetta). The aim behind this intervention is to reduce maternal mortality and achieving MDGs 4-5 in Pakistan.
Dr. Shershah Syed

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