The Use of Rectal Misoprostol as Active Pharmacological Management of the Third Stage of Labor

OBJECTIVE: To compare the effectiveness of rectal Misoprostol versus combined intramuscular oxytocin and ergometrine (O-E) in the management of the third stage of labor. METHODS: Low-risk women in 3rd stage of labor were allocated to receive either rectal Misoprostol [200micrograms (n = 25), 400 micrograms (n = 45)] or 5-units oxytocin and 0.2 mg ergometrine intramuscularly (n = 75). Clinical and hematological parameters were compared using t and chi-square tests. RESULTS: Both groups were well matched and had similar duration of the 3rd-stage of labor. Misoprostol users had lower 3rd-stage estimated blood loss and needed less further ecbolics compared to O-E group. Postpartum Hb and Hct levels were significantly lower in O-E group than Misoprostol group. Postpartum hypertension occurred more in O-E group. Subjects in Misoprostol group had more shivering. Subjects receiving 200 micrograms and 400 microgram Misoprostol had similar outcome variables. CONCLUSION: Rectal Misoprostol may be used safely in the management of the third stage of labor.