Publication:

Randomized comparative study of oral misoprostol with intravenous methyl ergometrine in prevention of postpartum haemorrhage in cases high risk for postpartum haemorrhage

Background Postpartum haemorrhage accounts for 30% of maternal deaths in rural areas. Active management of 3rd stage of labour with prophylactic uterotonics reduces the PPH up to 40%. The objective of our study was to compare the efficacy and side effects of Oral Misoprostol (600 µg) and Intravenous Methyl ergometrine (0.2 mg) in the prevention of PPH in cases high risk for PPH.

Methods One hundred high risk pregnant women at term in labour were included in the study and were randomly divided into 2 groups of 50 women each. Group I women were given 600µg Oral Misoprostol immediately after delivery of fetus and group II were given intravenous methylergometrine 0.2mg after delivery of anterior shoulder of fetus. The main outcome measures of third stage of labour studied were: duration; blood loss by volume, need for additional oxytocics, blood transfusion & side effects.

Results Demographic and clinical variables of both groups were comparable. There were no significant differences in main outcome measures between both the groups. Shivering was the most common side effect noted in misoprostol group.

Conclusions In high risk women oral misoprostol appears to be as effective as intravenous methylergometrine in minimizing 3rd stage blood loss. Misoprostol has greatest potential for use in 3rd stage of labour especially in developing countries.