TITLE:
Knowledge and Level of Use of Misoprostol by Health Care Providers in the Maternity Wards of South Kivu in the Practice of Obstetrics
AUTHORS:
De-Joseph Kakisingi Mibi, Julien Bwama Botalatala, Gloire Mubake Wabulakombe, Dieudonné Kakusu, Marie Constance Nguru Musese, Omari Mukanga, Luc Kalala, Moïse Kiminyi, Émile Mapatano Shalamba, Mukanire Ntakwindja, Olivier Nyakio
KEYWORDS:
Misoprostol, Postpartum Haemorrhage, Uterotonic
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.13 No.7,
July
27,
2023
ABSTRACT: Post-partum
haemorrhage (PPH) is one of the leading causes of maternal death in sub-Saharan
Africa. In developing countries, PPH is responsible for about 30% of maternal
deaths. The main causes of PPH are uterine atony, placental implantation
anomalies and coagulation disorders. Acting on the causes of post-partum
haemorrhage would significantly reduce maternal mortality. To prevent PPH, the
World Health Organization (WHO) recommends the use of uterotonics as a
preventive measure. Although parenteral Oxytocin is recommended as the first
line Oxytocic for the prevention of PPH, the use of misoprostol is increasingly
used in gynaecology and obstetrics, not only for the prevention of postpartum
haemorrhage, but also for many other obstetric indications. The aim of this
study was to assess the knowledge and level of use of misoprostol by healthcare
providers in the gynaecology and maternity departments of South Kivu in the
practice of gynaecology and obstetrics. Materials and Methods: We conducted a descriptive study from January 03 up
to February 04, 2023. The study of population was made up of healthcare workers in South Kivu. A questionnaire containing questions
relating to socio-demographic informations and knowledge of misoprostol was
prepared and encoded in the kobo collect software. To access the questionnaire,
it was compulsory to read the research protocol and give consent by ticking the
“yes” button. All those who ticked “no” were denied access to the
questionnaire. The link was sent, with a request to take part in the survey, to
groups in the social networks of doctors and midwives in South Kivu. For areas
not covered by the internet, a printed format was distributed and then encoded
by data entry operators. For the paper format, respondents were also asked to
indicate their consent by ticking the “yes” box. All the encoded data was
automatically compiled on the server and then analysed and interpreted by the
research team. Results: Nearly all (95.8%) healthcare workers in South Kivu knew about
Misoprostol, and only 4.2% did not. The majority (90.1%) of healthcare workers
had already used Misoprostol. Providers were aware of the obstetrical
indications for Misoprostol, but in most cases, they did not know the dosage
recommended by FIGO. For the prevention of post-Partum haemorrhage, only 39.9%
use the correct dosage, 42.7% for the treatment of incomplete miscarriage and
49.3% for the treatment of post-Partum haemorrhage. 10% to 21%
of providers know the indications of misoprostol but have no idea about dosage.
Providers were aware of all routes of administration, but in most cases, they
prescribed Misoprostol via the sublingual route (84.5%). The side effects
observed by the providers were those already observed in other studies.