Abstract
ABSTRACT Objective To determine the efficacy and safety of oral misoprostol with intravenous oxytocin and syntometrine in the active management of third stage of labor. Methodology 325 women were randomly allocated by convenient sampling to receive either 10 IU of intravenous oxytocin or 10 IU of oxytocin with 0.2 mg of Methergine (syntometrine) or 400 mcg of oral misoprostol at the delivery of anterior shoulder. Main outcome measures were estimation of blood loss > 500 ml, drop in hemoglobin/hematocrit levels and adverse effects of drugs. Results Estimated blood loss was significantly higher in group misoprostol group (p = 0.016) but comparable to oxytocin group (p = 0.40). Drop in hemoglobin level was comparable in all the three groups (p = 0.106). Drop in hematocrit value was significant for misoprostol and syntometrine (p = 0.022) but comparable to oxytocin. Nausea and vomiting was common in oxytocin and syntometrine group whereas fever and shivering was the leading adverse effect in misoprostol group. Conclusion Misoprostol is an effective and safe alternative to intravenous uterotonic agents in the active management of third stage of labor both at tertiary and community level.
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