Rectal Misoprostol versus Oxytocin in The management of the third stage of labor
Abstract
Objective: To compare the effectiveness of rectally used misoprostol in the active management of third stage of labor with intramuscular oxytocin. Methods: A comparative prospective study was performed at 2 hospitals in Basrah, 200 pregnant women in active labor were enrolled. Women were randomized to receive rectal misoprostol 600µg or intramuscular oxytocin 10 IU with delivery of the anterior shoulder. The primary outcome measures were the incidence of postpartum hemorrhage or change in Hb. concentration before delivery and 12hour after delivery. Secondary outcomes included the need for additional uterotonic agents, sever post partum hemorrhage ,blood transfusion , and medication side effects. Results: The percentage of PPH was 5% in the misoprostol group and 6% in oxytocin group (p >0.05). There were no significant difference among the groups in the drop of Hb. conc. (p>0.05). Secondary outcome measures including severe PPH and the duration of the 3rd stage of labor and medication side effects were similar in both groups. Conclusion: Rectal misoprostol 600µg is as effective as 10 IU intramuscular oxytocin in minimizing blood loss in the 3rd stage of labor. This confirms the utility of misoprostol as a safe and effective uterotonic drug for use in some areas where other pharmacologic agent may be less feasible.References
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