Postpartum haemorrhage is an important cause of maternal morbidity and mortality, accounting for nearly one quarter of all maternal deaths worldwide. The prophylactic use of oxytocic in the third stage of labor has shown to significantly reduce the risk of postpartum hemorrhaged by about 40%, implying that for every 22 women who are given such an oxytocic, one post partum hemorrhaged is prevented and its use is generally advocated in the management of third stage of labor.
Methods and Material: The present study of 400µg oral misoprostol vs 0.2mg intravenous methylergometrine for the active management of third stage of labor was conducted in the Department of Obstetrics and Gynecology of tertiary care hospital in Dehradun.
Results: In the present study there were 50 cases in each of the two groups. Majority of the cases were from urban area. The mean parity was 0.61±0.52 and 0.67±0.53 in Misoprostol and methylergometrine maleate group respectively (P=>0.05). Majority of the patients in the misoprostol group had third stage of labor of 10-12 minutes duration while in the methylergometrine maleate group, for majority of the patients the duration of third stage of labor was 5-6 minutes. In Misoprostol group side effects noted were shivering in 30% followed by fever 14%, Nausea 8%, vomiting 6% and pyrexia 4% cases, while in methylergometrine maleate group, nausea was observed in 20% followed by shivering 6%, vomiting 4% and Increase in diastolic blood pressure 4% cases. Conclusion: Although efficacy of both the drugs are comparable, even in presence of shivering which is a serious side effect but self-limiting with oral misoprostol offers. It is the simplest route desirable in developing countries where many of the deliveries are still being conducted at home especially in the rural areas, not attended by medically trained staff.