Warqad Furan :Bahda Caafimaad maamulka Soomaliland
Dawada Misoprostol : Ummul-gargaar ma ahee ,waa Ilmo soo rida !!
Waxaan telefishanka ETN TV ka daawaday dhiirigalin uu dhiirigalinayo mid ka mid ah madaxda caafimaadka
ee maamulka Soomaaliland ,dawada la yiraahdo Misoprostol . Waxay wasaarradda caafimaadka soomaliland u bixisay Ummul-gargaar ,iyadoo la leeyahay waxay joojisaa dhiig baxa haweenka ee uurka la xiriira !.
Maddaama ay dawadaas tahay mid caan ah ,isla markaasna aan waligeed loo isticmaalin dhiig joojin ,ayuu
hadalkii wasaaraddu igu dhaliyay inaan dib u baaro dawada iyo haddii ay jiraan wax cusub oo ku soo kordhay .
Maxaa loo isticmaalaa Misoprostol ?
Dawadaan waxay ka samaysan tahay Prostaglandin E1,waxaana loo isticmaali jiray in lagu daro
dawooyinka qaarkood ,gaar ahaan kuwa keena laab holaca( ama gasterikada-waa sida soomaalidu u taqaane) si ay uga hortagto . Waxay kaloo leedahay inay minka afkiisa furto ,islamarkaasna ay sababto nabar fooleed (contraction). Sidaasna ay ku sababi karto inay ilmaha uurka ku jira ku soo riddo(Abortion).
Dawadaan waa ka mamnuuc badi waddamada dadkooda ka fakara sida kuwa reer Yurub .Dunida badideedana kama diiwaan gashana . Haddii aad baartidna waxaa kuu soo baxaya inay jiraan qoraallo been abuur ah oo ay sameeyeen dadka ka ganacsadaa .Sida inay tahay dawo haweenka dhiig baxaya dhiigga ka joojisa .
Waddamada yar ee isticmaala waxay u isticmaalaan kaliya in gasterikaga looga hortago (to treat gastric ulcers associated with nonsteroidal anti-inflammatory drugs) iyo in Ilmaha aan la rabin haweenka looga soo rido , ayaandarrose waddamada Ethiopia ,Negeria ,Uganda iyo maamulka Somaliland waxaa laga dhaadhiciyay inay ummulaha u gargaarto oo dhiigga joojiso ,iyadoo aysan haba yaraatee jirin wax baaritaan ah oo caddaynaya ,marka laga reebo qoraalada been abuurka ah.
Dawadaan waxaa inta badan laga soo saaraa waddamada Masar iyo India .
Talo soo jeedin
Ugu horrayntii uma jeedo inaan cidna dhaleeceeyo ama aan sumcaddooda wax yeelo ,balse waxaan ka digayaa khatarta ay dawadani keeni karto .Waxaa shaqo maalmeedkayga ka mid ah inaan daweeyo ummulaha dhiig baxaya ama uurlayda dhiig baxaysa ,dawadaanna ka mid ma ahan dawooyinka aynu isticmaalno .Mana filayo inay aqoon xumo Denmark nagu haysee ,wanaag baan dawadaas lagu ogayn .
Waxaan ku takhasusay dawaynta dadka halista ah (intensive care unit) ,islamarkaasna waxaan ahay suuxiye .
Waxaan haddaba ka codsanayaa takhaatiir Soomaaliyeed inay dawadaas ka hortagaan ,lagana qabto hooyooyinka soomaaliyeed .
Waa in lagu baraarugaa haddii la siiyo hooyo uur leh ha dhiig baxayso ama yaysan dhiig bixine inay dawadani ilmaha ka soo ridi karto-Alle wayne diidin .
Ciddii doonaysa faahfaahin intaas ka badan haka eegto joornaalada caanka ah ee takhaatiirta amaba
aniga ha ila soo xiriirto.
Dr. Abdi Farah Ali
Department of anesthesiology And Intensive care unit .
Viborg Hospital
Denmark.
taano1@hotmail.com
waxay ila tahay ,inteenna gudaha dalka joogtaa xog badan baan ka haynaa dhibaatada dawooyinka lugu gado Somalia:waa in hal meel looga soo jeesto kuwa dawooyinka dhacay,kuwa loogu talogalay waddamada taag-ta yar ku qulqulinaya dalka Somaaliya.waa in ummadda fartiimo iyo talooyin saxa Takhaatiirtu u gudbisaa.
prof.Mohamed Jama
Consultant Neurosurgeon
Mudug Regional Hospital
Galkayo,Puntland State of Somalia
VBAC and Misoprostol
Misoprostol (brand name: Cytotec) is a prostaglandin product which can be applied to the cervix to induce labour. It is also known as Prostaglandin E1, but is not the same as the more common Prostaglandin E2 gel, dinoprostone. Misoprostol is cheaper than Prostaglandin E2, and apparently the induction to delivery interval is reduced, but uterine hyperstimulation appears more likely. This is particularly dangerous with VBAC candidates as the risk of uterine rupture is increased, compared with spontaneous labour, and also with induction by prostaglandin E2 gel and by oxytocin.
Marsden Wagner, retired from the World Health Organisation, has called for misoprostol induction on mothers attempting VBAC to stop, on the basis of the current evidence. You can read his views in the British Medical Journal.
A magazine article about this drug and its dangers for women attempting VBAC is on Salon.com:
Cytotec: Dangerous Experiment or Panacea? by Ina May Gaskin.
Here are summaries of some studies on misoprostol and VBAC attempts:
Disruption of prior uterine incision following misoprostol for labor induction in women with previous cesarean delivery
Obstet Gynecol 1998 May;91(5 Pt 2):828-30
Wing DA, Lovett K, Paul RH
Department of Obstetrics-Gynecology, University of Southern California School of Medicine, Los Angeles, USA
Researchers planned to compare misoprostol to oxytocin for induction of labour in mothers attempting a VBAC. After two uterine ruptures among just seventeen mothers receiving misoprostol, the trial was stopped on safety grounds. They concluded: “When misoprostol is used in women with previous cesareans, there is a high frequency of disruption of prior uterine incisions.”
**********
This study compares Misoprostol with Prostaglandin E2 gel:
Comparison of the safety and efficacy of intravaginal misoprostol (prostaglandin E1) with those of dinoprostone (prostaglandin E2) for cervical ripening and induction of labor in a community hospital.
Am J Obstet Gynecol 1999 Jun;180(6 Pt 1):1551-9
Blanchette HA, Nayak S, Erasmus S
MetroWest Medical Center, Department of Obstetrics and Gynecology, British Columbia, Canada.
Eighty-one mothers whose labour was induced with prostaglandin E2, were compared with one hundred and forty-five who were induced with misoprostol (prostaglandin E1).
The mean time between induction and birth was approximately a third shorter with misoprostol: 19.8 hours compared to 31.3 with prostaglandin E2. There was no significant difference in the cesarean delivery rate with misoprostol (25.6% vs 22.2%). There were no uterine ruptures among the 81 women induced with prostaglandin E2. However, among the 145 induced with misoprostol, there were 2 uterine ruptures and 1 dehiscence among mothers attempting VBACs, and 1 rupture in a mother with no prior caesarean. One baby died as a result of uterine rupture after misoprostol induction, but otherwise outcomes for the babies were similar.
CONCLUSIONS: “Compared with prostaglandin E2, misoprostol is more effective in cervical ripening and induction of labor, is as safe for patients who do not have a history of cesarean birth, may carry a higher incidence of uterine rupture, and should not be used for patients attempting vaginal birth after previous cesarean delivery”
It is surprising that the researchers considered misoprostol to be as safe as Prostaglandin E2 gel for mothers who did not have a history of caesarean births, since one woman in their study had a ruptured uterus in these circumstances. Uterine ruptures are very rare in mothers with unscarred wombs, so this result should raise questions rather than reassure.
Uterine rupture associated with the use of misoprostol in the gravid patient with a previous cesarean section
Am J Obstet Gynecol 1999 Jun;180(6 Pt 1):1535-42
Plaut MM, Schwartz ML, Lubarsky S
Department of Obstetrics, Northwest Permanente PC, British Columbia, Canada.
Out of 89 women attempting VBAC whose labours were induced with misoprostol, 5 suffered uterine ruptures. However, among 423 women attempting VBAC who did not receive misoprostol, only one suffered a rupture. The rupture rate for VBAC candidates after misoprostol induction was therefore 5.6%, compared to 0.2% otherwise.
CONCLUSION: Misoprostol may increase the risk of uterine rupture in the patient with a scarred uterus. Carefully controlled studies of the risks and benefits of misoprostol are necessary before its widespread use in this setting.
Uterine rupture during preinduction cervical ripening with misoprostol in a patient with a previous Caesarean delivery
Aust N Z J Obstet Gynaecol 1998 Feb;38(1):96-7
Sciscione AC; Nguyen L; Manley JS; Shlossman PA; Colmorgen GH
Department of Obstetrics and Gynecology, Medical Center of Delaware, Newark, USA.
A single case study where a mother with a previous low transverse Caesarean delivery suffered a uterine rupture after transvaginal misoprostol was used.
Hi Doc,
Thanks for disseminating this information, I am in Hargeisa and will find out this useful piece of medical ethics, I haven’t heard this news before
Regards