A RANDOMIZED CONTROLLED-STUDY OF PROSTAGLANDIN 15-METHYL F2-ALPHA COMPARED WITH SYNTOMETRINE FOR PROPHYLACTIC USE IN THE 3RD STAGE OF LABOR

A randomized controlled study of 112 women with singleton pregnancies at term, and no antenatal complications, admitted in spontaneous labou r were randomized to receive either an intramuscular injection of 0.5 mg of Syntometrine or an intramuscular injection of 125 ug of prostagl andin 15-methyl F2 alpha at delivery of the anterior shoulder of the b aby. Blood lost in the first 2 hours, and subsequent 22 hours postdeli very were collected separately and measured by colourimetric measureme nt of haemoglobin content. Other parameters in the third stage were me asured, including need for transfusion of blood or blood products, len gth of the third stage, and change in haemoglobin concentration before and 24 hours after delivery. The incidence of side-effects with admin istration of either prostaglandin 15-methyl F2 alpha or Syntometrine w ere documented. The prophylactic use of intramuscular prostaglandin 15 -methyl F2 alpha (Carboprost) in the active management of the third st age of labour gave similar results to prophylactic intramuscular Synto metrine in terms of length of the third stage of labour, incidence of postpartum haemorrhage and total blood loss in the first 2 hours and s ubsequent 22 hours after delivery. However it has the disadvantage of higher cost, as well as statistically significant increase in the inci dence of profuse and frequent diarrhoea. Based on these results intram uscular injection of prostaglandin 15-methyl F2 alpha offers no advant age over intramuscular Syntometrine for routine prophylactic use to re duce blood loss in the third stage of labour.