Obstetricians raise red flag over inappropriate use of misoprostol

Misoprostol is used to stop excessive bleeding after child birth. It helps contract the uterus and thereby control blood flow.

Dr. Innocent Nkonwa, the Luweero District Health Officer, says the inappropriate usage of misoprostol has cost some women their lives and led to various complications among others.

The inappropriate use of misoprostol is one of the issues that came up during the Annual Reproductive, Maternal and Child Health symposium in Kampala.

The medical experts noted that while misoprostol has been included on the list of essential medicines as one of the life savers, there is need to put in place proper guidelines and monitoring usage.

Dr. Charles Kiggundu, a consultant obstetrician at Kawempe National Referral Hospital, says the new guidelines allow health workers to give expectant mothers a dose of the drug comprising three tablets to take home as a form of prophylaxis.

Dr. Kiggundu said the decision to give the drug to expectant mother was reached following a pilot study, which showed that it saves lives for women who deliver before reaching a health facility since health workers give them specific instructions on how it should be used after delivery.

Its use before delivery to induce labor, he said can be dangerous to both the mother and the unborn baby as the drug is a high dose that can cause the loaded uterus to rapture.

Initially, ,misoprostol was used for treating gastric ulcers by regulating the production of acid in the stomach.  Dr. Kiggundu notes that while in use it was realized that one of its side effects was causing bleeding and causing miscarriages so it wasn’t recommended for use during pregnancy.

However, it was also discovered to be beneficial because it causes the uterus to contract and expel what is inside the cavity.  In Uganda, it was decided 15 years ago that the drug be used to stop excessive bleeding.

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