Recorded presentation

Ndola Prata, MD, MSc¹, Reginald Gipson, MD, MPH², Sabry Hamza, MD², and Amr Fathy Abdel-Karim, MD². (1) Bixby Population Program, University of California, Berkeley, 1213 Tolman Hall, UC-Berkeley, Berkeley, CA 94720, 5106434284, NDOLA@BERKELEY.EDU, (2) Healthy Mother / Healthy Child, John Snow, Inc., 21 MISR Helwan Agricultural Rd., 10th floor, Maadi, Cairo, Egypt

According to the 2000 National Maternal Mortality Study in Egypt, hemorrhage was the leading contributor to maternal mortality. It was associated with 48% of direct obstetric deaths and 38% of all deaths. Postpartum hemorrhage (PPH) alone was responsible for 27% of all maternal deaths, making it the single most important cause of maternal death. Proven methods of controlling PPH are documented and the WHO recommends active management of the third stage of labor with uterotonics, preferably oxytocin. However, the instability of oxytocics in tropical climates and lack of health professionals to give injections limits the parenteral use of drugs. Recently, international organizations such as FIGO and the Bellagio conference recommended active management of the third stage of labor with uterotonics including misoprostol. The USAID funded Healthy Mother/Healthy Child Project in Egypt is conducting an operations research study to confirm that for the management of the third stage of labor, prophylactic administration of 600 micograms of oral misoprostol will reduce blood loss, therefore reducing post-partum hemorrhage associated morbidity. The study is being conducted in five university hospitals in Egypt over a period of four months and includes a non-intervention phase and an intervention phase. Study results will be used by the Egyptian MOHP to revise their current policies on the active management of the third stage of labor.

Learning Objectives:

• 1. Recognize the importance of active management of the third stage of labor.
• 2. Describe the effects of prophylactic administration of 600 micograms of oral misoprostol during the third stage of labor.
• 3. Analyze changes in postpartum blood loss following administration of misoprostol

Presenting author's disclosure statement:
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: I am employed by the organization who conducted the study

Recorded presentation