The use of rectal misoprostol as active pharmacological management of the third stage of labor.
OBJECTIVE
To compare the effectiveness of rectal Misoprostol 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 Misoprostol [200micrograms (n = 25), 400 micrograms (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. Misoprostol 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 Misoprostol group. Postpartum hypertension occurred more in O-E group. Subjects in Misoprostol group had more shivering. Subjects receiving 200 micrograms and 400 microgram Misoprostol had similar outcome variables.


CONCLUSIONS
Rectal Misoprostol may be used safely in the management of the third stage of labor.
Diab
K M
KM
Department of Obstetrics and Gynaecology, Ain Shams University, Cairo, Egypt.
Ramy
A R
AR
Yehia
M A
MA
D000285:Administration, Rectal; D000328:Adult; D004874:Ergonovine / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D006801:Humans; D007273:Injections, Intramuscular; D007749:Labor Stage, Third; D016595:Misoprostol / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D010120:Oxytocics / Q000008:administration & dosage* / Q000627:therapeutic use; D010121:Oxytocin / Q000008:administration & dosage / Q000009:adverse effects; D011247:Pregnancy; D016896:Treatment Outcome
D010120:Oxytocics; D016595:Misoprostol; D010121:Oxytocin; D004874:Ergonovine