A Comparative Study: Is Misoprostol as Effective as Oxytocin in Active Management of Third Stage of Labor?

Background: The third stage of labor is that periodfrom birth of the infant until the delivery of theplacenta. Active management of the third stage oflabor plays an important role in reducing maternalmorbidity and mortality. Oxytocin is an effectivedrug in preventing postpartum hemorrhage (PPH)however; it requires a controlled environmentand intramuscular administration.Misoprostol isan orally active uterotonic agent,stable at roomtemperature.The purpose of this study was tocompare the efficacy of misoprostol with oxytocinin active management of third stage of labor. Materials and Methods: This was a hospitalbased study carried out in Paropakar Maternityand Women Hospital, Kathmandu, Nepal duringsix months period from February 2012 to July2012. One hundred patients fulfilling inclusioncriteria were recruited to receive either 10 unit ofIM oxytocin or 600 mcg of oral misoprostol for themanagement of the third stage of labor. Results: The mean blood loss in misoprostol andoxytocin group was 209±76.7ml and 197±68.8ml respectively with p value-0.41 which wasinsignificant. Similarly mean hemoglobin changewas also not significant. The additional uterotonicsneeded in misoprostol was higher (9 cases) than thatin oxytocin (5 cases) but it was also not significant.Shivering and fever were significantly high amongmisoprostol group than in oxytocin group. Conclusion: Efficacy of oxytocin and misoprostolis equal in active management of third stage of labor.