Rectal misoprostol versus oxytocin in the prevention of postpartum hemorrhage — A pilot study

Abstract

Oxytocin has been the oxytocic of choice for Active Management of Third Stage of Labor (AMTSL) [1]. Misoprostol would be a suitable alternative in low resource settings where drug delivery is hampered by storage and problems of parenteral administration. In patients who are vomiting, unable to take medications or under anesthesia, rectal administration may be associated with fewer side effects and ease of administration [2].The use of additional uterotonics is significantly higher with rectal 400 mcg misoprostol than with oxytocin [3]. It is possible that a higher dose of rectal misoprostol may be more effective in reducing blood loss. A prospective, double-blind, randomized pilot study was undertaken in the Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India to determine the effectiveness and safety of rectal administration of 600 mcg misoprostol compared to oxytocin as part of the AMTSL in women at low risk for PPH. The study was approved by the ethical committee of the Institute. Two hundred women in spontaneous labor were recruited, and a written informed consent was ob-