RANDOMIZED CONTROLED DOUBLE MASKED COMPARISON OF RECTAL MISOPROSTOL WITH INTRAVENOUS OXYTOCIN AND ERGOMETRINE FOR ACTIVE MANAGEMENT OF THIRD STAGE OF LABOR

Abstract

This randomized double-blind clinical trial was carried in Ain Shams University Hospital on three hundred women were admitted for vaginal delivery and participated in this study after counseling. Our aim was to evaluate the effect of rectal admini­ stration of misoprostol compared to combined ergometrine and oxytocin and ergometrine alone administered intravenously as a uterotonic agent on blood loss in third stage of labor. All subjects were at low risk for postpartum hemorrhage and . subjects with history of antepartum haemorrhage, multiple pregnancy, intrauterine death, women with a history of postpartum haemorrhage in previous deliveries, grandmultiparous women and those with hypertension or cardiac troubles during the current pregnancy or with previous uterine scar or those on anticoagulant medication were excluded. Randomization was carried out using •table of random numbers. Efforts to obtain identical placebo tablets to misoprostol tablets were unsuccessful but with the help of pharmacest misoprostol was prepared as rectal suppository identical to non­ medicated suppository containing the fatty base witepsol. There were identical in colour odour and shape. 2 ml saline was used as placebo for both oxytocin and ergometrine. Subjects were classified into 3 groups: Misoprostol group (M-group): Women received intravenous saline solution with the medicated suppository, i.e., containing 400 meg misoprostol (Cytotec, Searle UK).