The use of misoprostol for postpartum haemorrhage among midwives in primary healthcare facilities in Edo state, Nigeria.

Abstract
Background: Postpartum haemorrhage is a leading global cause of maternal morbidity and mortality. The use of misoprostol in the prevention and treatment of PPH has been shown to be effective particularly in low resource settings where regular supply and maintenance of efficacy of oxytocin and ergometrine cannot be ensured. This study aimed to determine midwives'knowledge and usage of misoprostol in the management of Postpartum haemorrhage in Edo Central Senatorial District.

Methodology: It was a descriptive cross-sectional survey involving 126 midwives. An allinclusive sampling was adopted for the study. Data was collected by means of a structured questionnaire. Collected data were analysed and presented by means of frequencies and percentages. Pearson's correlation analysis was used to test the hypotheses.

Results: This study showed that 40.5% and 42.9% of respondents knew the correct dose, 77%and 46.8% knew the correct route and 37.3%and 77.8%knew the correct time of administration for prevention and treatment of PPH respectively. In the prevention of PPH, 42.9%of respondents administer misoprostol at the correct time, 46.8%at the correct dose and 66.7%through the correct route whereas, in the treatment of PPH, 62.7% of respondents administered misoprostol at the correct time, 43.7% at the correct dose and 54% through the correct route. Only 38%of respondents
had received training on use of misoprostol for PPH. Factors influencing misoprostol use among the participants were training, adequate knowledge, availability, and effectiveness of misoprostol. There was a significant relationship between midwives' professional qualifications and years of service and correct use of misoprostol.

Conclusion: Theknowledge of misoprostol use was still low, and midwives still used misoprostol incorrectly in the management of PPH. It is recommended that relevant authorities should invest in training and retraining of midwives on use of misoprostol for the management of PPH.

KEYWORDS: Post Partum Haemorrhage, misoprostol, prevention, treatment, factors.