Misoprostol Versus Oxytocin in the Active Management of the Third Stage of Labour

Abstract

Objective: A randomised controlled trial was performed in Sir Solimullah Medical College Mitford Hospital, a tertiary hospital in Dhaka City for one year to compare oral misoprostol with intramascular oxytocin in the prevention of post partum haemorrhage (PPH). Method: A total of 400 women were randomised to received either 400mg misoprostol orally or 10 I.U oxytocin intramascularly. The incidence of post partum haemorrhage and side effects were examined. Result: The demographic and labour characteristic were comparable. PPH occured in 3.80% of women given misoprostol and in 2.63% of those given oxytocin (P>0.50). Measured blood loss of more than 1000 ml occured 2.38% of the misoprostol group compared with 1.58% in the oxytocin group (P>0.50). There was no significant difference in the need for additional oxytocin drugs or blood transfusion in women of both groups. Significant side effect of misoprostol were shivering (P<0.01). Conclusion: Oral misoprostol is as effective as intramascular oxytocin in the prevention of PPH. Shivering and transient pyrexia were special side effects of misoprostol. Misoprostol has potential in reducing the high incidence of PPH in developing countries. (J Bangladesh Coll Phys Surg 2007; 25 : 73-76)