PREVENTION OF POST PARTUM HAEMORRHAGE BY RECTAL MISOPROSTOL. A RANDOMISED CONTROLLED TRIAL

Objective: To assess the effectiveness of rectally used misoprostol in the prevention of postpartum hemorrhage compared with oxytocin. Materials and Methods: 402 women underwent analysis and were randomized to receive either two 200 micrograms rectal misoprostol tablets (study group) or 20 units oxytocin in 50 cc normal saline intravenously (control group). Primary outcome measures were the incidence of postpartum hemorrhage or a change in hematoctrit or hemoglobin from admission to day one post delivery. Results: The incidence of postpartum hemorrhage was 7% in the study subjects and 6% in the control subjects (P>0.05) There were no significant difference among the groups in the drop of hematocrit (P>0.05). Secondary outcome measures including severe postpartum hemorrhage and the duration of the third stage of labour were similar in both groups. Conclusion: Rectal misoprostol is as effective as intravenous oxytocin in preventing postpartum hemorrhage with the same incidence of side effects and is recommended to be used as a uterotonic agent for the routine management of third stage of labour.