A prospective randomized controlled trial for comparison of oral misoprostol with methyl ergometrine in the third stage of labour for prevention of post-partum haemorrhage
Keywords:Management, Methyl ergometrine, Misoprostol, Postpartum haemorrhage
Background: Near about 11% of women having live births have severe PPH (Globally 14 million women per year). About 3.9% of vaginal deliveries and 6.4% of cesarean section get PPH. Near about 1.4 million women die of PPH every year. Frequency of PPH is related to management of third stage of labour. Objective of the study was to compare the efficacy of misoprostol with conventional oxytocics for active management of third stage of labour.
Methods: The present study was carried out in tertiary care teaching hospital for a period of three years from June 2007-May 2010. A total of 364 study participants who reported to labour ward with labour pains in latent phase and subsequently went in spontaneous labour were enrolled and randomly distributed to two groups and given oral misoprostol and i.v. ergometrine.
Results: The mean age in Group A was 23.17±2.55 and 24.31±3.28 respectively. It was observed that most the study participants in both the groups had the duration of third stage of labour in between 10-14 minutes i.e. 29% in Group A and 36.3% in Group B respectively. The duration of third stage of labour was significantly more in Group B compared to Group A.
Conclusions: Misoprostol is a promising drug in the management of third stage of labour for the prevention of post- partum haemorrhage.
Abouzahr C. Antepartum and Post partum Haemorrhage. In: Murray CJL, Lopez AD, eds. Health dimensions of sex and reproduction. Boston: Harvard University Press.1998;3.
Smith JR, Barabara BG. Management of third stage of labour. Available at http:// emedicine.medscape. com/article/275304-media (cited 2016 Dec 12).
Smith JR. Post partum haemorrhage. Available at http://www.emedicine.com (cited 2016 Dec 12).
Vimala N, Mitthal S, Kumar S, Dadhwal V, Mehta S. Sublingual misoprostol versus methyergometrine for active management of the third stage of labour. Int J Gyneacol Obstet. 2004;87(1):1-5.
Rana S. Post partum haemorrhage in obstetrics and perinatal care for developing countries, Islamabad, Pakistan. Saf publications. 1998;1:1080-102.
Shaheen F, Jeen J. Post partum haemorrhage: Still a challenge. J Rawal Med Coll. 2003;7:77-81.
Kundodyiwaa TW, Majokoa F, Rusakanikob S. Misoprostol versus oxytocin in the third stage of labour. Int J Gyneacol Obstet. 2001;75(3):235-41.
Amant F, Splitz B, Timmerman D. Misoprostol compared with methylergometrine for the prevention of post partum haemorrhage: A double blind ramdomized trial. Br J Obstet Gynaecol. 1999;106:1066-70.
Ng P S. A multicentric randomized controlled trial of oral misoprostol and im syntometrine in the management of the third stage of labour. Hum Reprod. 2001;16:31-5.
Langenbach C. Misoprostol in preventing post partum haemorrhage: a meta analysis. Int J Gynaecol Obstet. 2000;92:8-10.