Control of Postpartum Bleeding by Rectal Misoprostols: A Report of 2 Cases.

Han, Seong Tae; Jung, Seok Hee; La, Yeon Hwa; Seo, La Lae; Jung, Woo Chuel; Lee, Sung Won; Cho, Yong; Ro, Eu Sun

Case Report

Korean Journal of Obstetrics & Gynecology 2000;43(4):747-750.
Published online January 1, 2001.

Control of Postpartum Bleeding by Rectal Misoprostols: A Report of 2 Cases.

Seong Tae Han, Seok Hee Jung, Yeon Hwa La, La Lae Seo, Woo Chuel Jung, Sung Won Lee, Yong Cho, Eu Sun Ro

Abstract

Obstetrical hemorrhage is one of the deadly triad, along with hypertensive disorder in pregnancy and infection. Postpartum hemorrhage is the major cause of obstetrical hemorrhage. Uterine atony is the most common cause of postpartum hemorrhage, and resulted from poor uterine contraction after delivery of the fetus and placenta. Initial management to control postpartum uterine atonic bleeding is based on the use of uterotonics such as well known oxytocin and ergot preparations together with uterine massage. Prostaglandin E2 analogue, sulprostone can be used next when these agents are failed to produce uterine contraction. The woman unresponsive to non-surgical managements requires surgical interventions including emergency hysterectomy. Recently prostaglandin E1 analogue, misoprostol, has been known to elicit potent uterine contraction and cervical ripening after oral, vaginal or rectal administration. We have experienced two cases of postpartum uterine atonic bleedings which were unresponsive to oxytocin, ergot, or prostaglandin E2, but were successfully controlled by rectal administration of misoprostols.

Key Words: Postpartum hemorrhage, Uterine atony, Misoprostol