400 mu g oral Misoprostol versus 0.2mg intravenous Methyl ergometrine for the active management of third stage of labor

Objectives: The present study was conducted with the aim to assess and comparatively evaluate the safety and efficacy of oral misoprostol 400 mu g and I/V methylergometrine 0.2mg in the active management of third stage of labor. Methods: The study was conducted in the department of Obstetrics & Gynaecology Pt. J.N. M. Medical College, Raipur (C.G.) and associated Dr. B.R. A. M. Hospital from January 2006 to July 2006. The 200 cases selected for the study were divided in two groups of 100 cases each. In the study group misoprostol 400 mu g was given orally and in the control group 0.2mg methylergometrine was given intravenously at the time of the delivery of anterior shoulder of the fetus. The duration of the third stage, amount of blood loss, side effect and complications if any were noted down. The results were analyzed. Results: The mean duration of the third stage of labor in the study group was 10.17 +/- 6.87 minutes as compared to 5.68 +/- 1.91 minutes in the control group (P=<0.001). The mean blood loss in the study group was 117.28 +/- 99.77 ml as against 124.58 +/- 64.19 ml in the control group (P=>0.05). The side effects observed in the misoprostol group were shivering, fever and in methylergometrine group were nausea, vomiting & headache. Conclusions: Oral misoprostol is an effective alternative to conventional uterotonics for the active management of third stage of labor.