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A Comparative Study of Oxytocin/Misoprostol/Methylergometrine for Active Management of the Third Stage of Labor

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Abstract

Objectives

To study oxytocin, misoprostol, and methylergometrine in active management of the third stage of labor and determine duration of the third stage of labor, blood loss, adverse effects, and need for additional uterotonics in each group.

Methods

Clinical trial of 300 women with healthy singleton pregnancy allocated into three groups to receive either: 10 IU intravenous oxytocin infusion, 600 μg sublingual misoprostol, or 200 μg intravenous methylergometrine. Primary outcome measure was blood loss in the third stage of labor; secondary measures were duration of the third stage, side effects, and complications.

Results

Subjects who received 600 μg of misoprostol had the least blood loss, followed by oxytocin, and methylergometrine. The shortest mean duration of the third stage was with misoprostol. Shivering and pyrexia were observed in misoprostol group, and raised blood pressure in methylergometrine group.

Conclusions

Misoprostol is as effective as oxytocin and both are more effective than methylergometrine in active management of the third stage of labor.

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References

  1. Kaul V, Bagga R, Jain V, et al. The impact of primary postpartum hemorrhage in “Near-Miss” morbidity and mortality in a tertiary care hospital in North India. Indian J Med Sci. 2006;60:233–40.

    Article  PubMed  Google Scholar 

  2. Mathai M, Gülmezoglu A, Hill S. WHO recommendations for the prevention of postpartum hemorrhage. Geneva: WHO Document Production Services; 2007. p. 4–5.

    Google Scholar 

  3. Soltan MH, El-Gendi E, Imam HH, et al. Different doses of sublingual misoprostol versus methylergometrine for the prevention of atonic postpartum hemorrhage. Int J Health Sci (Qassim). 2007;1(2):229–36.

    CAS  Google Scholar 

  4. Tang OS, Schweer H, Seyberth HW, et al. Pharmacokinetics of different routes of administration of misoprostol. Hum Reprod. 2002;17(2):332–6.

    Article  CAS  PubMed  Google Scholar 

  5. Ng PS, Chan AS, Sin WK, et al. A multicentre randomized controlled trial of oral misoprostol and i.m. syntometrine in the management of the third stage of labor. Hum Reprod. 2001;16(1):31–5.

    Article  CAS  PubMed  Google Scholar 

  6. El-Refaey H, Nooh R, O’Brien P, et al. The misoprostol third stage of labor study: a randomized controlled comparison between orally administered misoprostol and standard management. BJOG. 2000;107(9):1104–10.

    Article  CAS  PubMed  Google Scholar 

  7. Walraven G, Blum J, Dampha Y, et al. Misoprostol in the management of the third stage of labor in the home delivery setting in rural Gambia: a randomized controlled trial. BJOG. 2005;112(9):1277–83.

    Article  CAS  PubMed  Google Scholar 

  8. Gohil JT, Tripathi B. A study to compare the efficacy of misoprostol, oxytocin, methyl-ergometrine and ergometrine-oxytocin in reducing blood loss in active management of 3rd stage of labor. J Obstet Gynaecol India. 2011;61(4):408–12.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  9. Tunçalp Ö, Hofmeyr GJ, Gülmezoglu AM. Prostaglandins for preventing postpartum hemorrhage. Cochrane Database of Syst Rev. 2012;8:CD00494. doi:10.1002/14651858.CD000494.pub4.

    Google Scholar 

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Conflict of interest

The authors have no conflicts of interest.

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Correspondence to Parneet Kaur.

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Sharma, M., Kaur, P., Kaur, K. et al. A Comparative Study of Oxytocin/Misoprostol/Methylergometrine for Active Management of the Third Stage of Labor. J Obstet Gynecol India 64, 175–179 (2014). https://doi.org/10.1007/s13224-014-0512-9

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  • DOI: https://doi.org/10.1007/s13224-014-0512-9

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