Publication:

A comparative study of efficacy of oxytocin, methylergometrine and misoprostol in prevention of post-partum haemorrhage

Background To compare the efficacy of oxytocin, methylergometrine and misoprostol in active management of third stage of labour (AMTSL).

Methods A clinical study was conducted on 330 low risk pregnant women with a healthy singleton pregnancy and spontaneous onset of labour at term; allocated into three groups where active management of third stage of labour was done with either Oxytocin 10 IU intramuscular, or Methylergometrine 0.2 mg intramuscular, or tab Misoprostol 600µg sublingual on 110 women each group. Primary parameter was blood loss during labour. Secondary parameters were the duration of third stage of labour and changes in haemoglobin level.

Results Blood loss during labour in Oxytocin group was 145.86±11.53 ml, which was significantly less than that in Methylergometrine (164.02±9.36 ml) and Misoprostol groups (183.18±9.70 ml), but no patient in any of the groups had blood loss more than 200ml. Duration of third stage of labour was significantly less in Oxytocin group (5.13±1.91 mins) than in. Methylergometrine (6.16±1.85 mins), and Misoprostol groups (6.47±1.51 mins). No patient had prolonged third stage in any of the groups. There was no significant change in pre-and post-delivery haemoglobin levels in all the groups.

Conclusions Though injectable uterotonics are effective for active management of third stage of labour (AMTSL), misoprostol can also be effectively used, especially in settings where there is no adequate trained personnel and drug storage facility.