Abstract
OBJECTIVE: Objective of study was to determine the effectiveness of misoprostol in management of primary PPH and look for its adverse effects.
MATERIAL AND METHOD: It was an interventional quasi experimental study conducted in Allied hospital, Faisalabad from March 2008 to August 2008. All patients with postpartum hemorrhage due to uterine atony, delivered in the hospital were evaluated with detailed history and thorough general, abdominal and vaginal examination in order to meet the inclusion and exclusion criteria. Resuscitative measures were continued during this period and blood sample of the patients taken for cross matching and complete blood count, Prothrombin time (PT) and activated Partial Thromboplastin time (aPTT). Their demographic profile [age, parity, booking status], mode of delivery and success rate of misoprostol checked in terms of hemodynamic status, uterine contractility, reduction in blood loss and side effects profile.
RESULTS: Hundred patients were selected who suffered from PPH due to uterine atony. The age of patients ranged between 18 and 40 years with mean age of 28 years ±5.83SD, 60 patients [60%] were unbooked, 80 females [80%] were delivered by vaginal route. Out of 100 patients, 72 cases (72%) responded well to misoprostol (P=0.002). Those who failed to respond were treated by other treatment modalities.
CONCLUSION: Misoprostol is an effective drug to be used in treatment of primary post partum hemorrhage due to uterine atony. It is inexpensive, stable at room temperature, easy to administer, can be handled by untrained person with minimum side effects. These qualities can be extrapolated for its use in community by mid wives and traditional birth attendants.

Key words: Post partum hemorrhage, misoprostol, uterine atony, uterotoics agent