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

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Abstract
Objective: To compare the effectiveness of rectal Misoprostolr̀ 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 Misoprostolr̀ [200 ug (n = 25), 400 ug (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. Misoprostolr̀ 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 Misoprostolr̀ group. Postpartum hypertension occurred more in O‐E group. Subjects in Misoprostolr̀ group had more shivering. Subjects receiving 200 ug and 400 ug Misoprostolr̀ had similar outcome variables.Conclusion: Rectal Misoprostol may be used safely in the management of the third stage of labor.

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