English

Abstract

BACKGROUND AND OBJECTIVES: To compare the management of third stage of labour by 400µg rectal misoprostol versus intramuscular 125 µg PGF2α and to study the side effects of the drugs. METHODS: 200 low risk women at term with spontaneous labour were studied and were randomly divided into 2 groups. Group – I were administered per rectal misoprostol 400 µg and group – II PGF2α – 125 µg respectively at delivery of anterior shoulder of foetus. Outcome with regard to duration of III stage of labour, amount of blood loss, difference in haemoglobin, need for additional oxytocics and side effects were studied. RESULTS: Significant reduction in duration of third stage (P < 0.05) and blood loss (P < 0.05) was seen in PGF2α (125 µg) group compared to misoprostol. Reduction in Hb% postpartum (after 48 hours) was also significantly less in PGF2α (125 µg) group vs.misoprostol group. Need for additional oxytocics was more in misoprostol group (10 cases) when compared to PGF2α group 17 cases. In both groups, 1 patient had retained placenta. In PGF2α gp., GI side effects like nausea (13%), vomiting (3.5), abdominal cramps (17.5%) were seen. While misoprostol group had low incidence of GI side effects; nausea (6.5%), vomiting (2%), pyrexia (18%) and shivering (24%) were seen in a higher incidence. CONCLUSION: PGF2α results in more effective reduction in duration of third stage of labour, lesser blood loss, significantly lesser reduction in Hb level after delivery and is associated with side effects like nausea, vomiting, diarrhoea and abdominal cramps while per-rectal misoprostol is less effective but with side effects like pyrexia and shivering.