Misoprostol versus Oxytocin in Prevention of Postpartum Hemorrhage

Study background: The present study was done to compare oxytocin and misoprostol in active management of third stage of labor. Materials and methods: Total of 200 pregnant women were enrolled in the study were divided into two randomized groups. Group ‘A' included 100 primigravidas with singleton pregnancy and normal vaginal delivery, who received 600μg misoprostol sublingually with delivery of baby. Group ‘B' included equal number of primigravidas with singleton pregnancy, who underwent normal vaginal delivery and received 10 IU intramuscular oxytocin after delivery of anterior shoulder of baby. Results: The fall in hemoglobin was ? 1 g/dl in 6% of oxytocin group and 8% of misoprostol group and mean blood loss was comparable in the two groups (p = 0.455). None of the cases had mean amount of blood loss ? 1000 ml. Incidence of postpartum hemorrhage within an hour of delivery in misoprostol and oxytocin group was 8% and 6% respectively which was comparable (p = 0.435). Occurrence of nausea, vomiting, diarrhea, were also not significantly different between groups (p = 0.102, 0.071, 0.700 respectively) while fever (? 38 °C) and shivering was significantly present more in misoprostol group (p = 0.001). Vertigo was present in 2% of misoprostol and 3% of oxytocin group and the difference was not significant (p = 0.651). Conclusions: Misoprostol and oxytocin both were equally effective in prevention of postpartum hemorrhage Though shivering and pyrexia are its specific side effect but they were transient; thus Misoprostol appears to be a safe, inexpensive, thermostable, long shelf life without special storage and effective uterotonic for use in rural and remote areas where parentral oxytocin may be unavailable. It can be given to birth attendants for routine use in third stage of labor especially in rural settings.