use of oral and rectal misoprostol in management of third stage of labor

ABSTRACT

To compare the effectiveness of oral and rectal misoprostol versus combined intramuscular oxytocin and ergometrine in the management of third stage of labor. Women with low risk for post-partum haemorrhage in the 3[rd] stage of labor were allocated to review either oral misoprostol [600 ug, n = 100], or rectal misoprostol [400 ug, n = 100], or intramuscular syntometrine [5/U oxytocin and 0.5mg eryometrine, n = 100]. Clinical and hematological parameters were compared. Oral and rectal misoprostal had similar outcome variables the duration of the 3rd stage of labor and rate of manual separation of the placenta were less in misoprostol users. They also had lower 3rd stage blood loss, needed less ecobolics and none of them needed blood transfusion compared to syntometrine user. Post-partum Hb and Hct levels were significantly lower in syntometrine group than misoprostol groups. Post-partum hypertension seen more with syntometrine, while in misoprostol women had more shivering. Oral and rectal misoprostol can be used safely in the management of the 3[rd] stage of labor