Misoprostol for prevention of postpartum hemorrhage

Objective: To compare the effectiveness of 400 mug rectal misoprostol in 5 cm(3) of saline with oxytocin 10 IU, i.m., in reducing bleeding during the third stage of labor. Design: A double blind, randomized, clinical trial in cluding 663 women with uncomplicated vaginal delivery who received misopros tol (n = 324) or oxytocin (n = 339). Main outcome measures: Changes in hemo globin and hematocrit from before to 72 h postpartum; blood loss during the third stage; duration of the third stage of labor; need for additional oxy tocic drug; frequency of requisition and of administration of blood; change s in blood pressure; and occurrence of side effects. Results: No significan t differences were observed between groups, before and 72 h postpartum, in mean hemoglobin and hematocrit, on volume of blood loss and duration of thi rd stage of labor. The incidence of shivering and mean temperature (P < 0.0 1) was significantly greater among women receiving misoprostol than oxytoci n. Conclusions. Misoprostol administered as a micro-enema, 400 mug in 5 mi of saline during the third stage of labor, appears to be as effective as ox ytocin 10 IU, i.m., but misoprostol produced more side effects than oxytoci n. (C) 2001 International Federation of Gynecology and Obstetrics. All righ ts reserved.