Rectal misoprostol versus intravenous oxytocin for prevention of postpartum hemorrhage.
OBJECTIVE
To assess the effectiveness of 800 microg of rectal misoprostol compared with an intravenous infusion of 5 IU of oxytocin as prophylaxis against postpartum hemorrhage (PPH).


METHODS
A total of 514 women in labor were randomized into two groups (257 women in each). Within 1 minute of delivery of the anterior shoulder participants in group 1 received 800 microg of rectal misoprostol and 1 ampoule of normal saline in 5 mL lactated Ringer solution intravenously; group 2 received a rectal placebo tablet and 5 IU of oxytocin in 5 mL lactated Ringer solution intravenously.


RESULTS
Both groups were comparable regarding the need for uterotonics, blood transfusion, and hematocrit drop of 10% or greater, 24 hours post partum (P=0.54, P=0.25, and P=0.85, respectively). Fever was significantly higher among misoprostol patients (18.7% vs 0.8%, P<0.001).


CONCLUSIONS
Routine use of 800 microg of rectal misoprostol was effective in reducing blood loss after delivery. We recommend the regimen for low-resource, busy obstetric settings.
Nasr
Ahmed
A
Department of Obstetrics and Gynecology, Women's Health Center, Assiut University, Assiut, Egypt. a_nasr02@lycos.com
Shahin
Ahmed Y
AY
Elsamman
Ali M
AM
Zakherah
Mahmoud S
MS
Shaaban
Omar M
OM
D000285:Administration, Rectal; D000328:Adult; D001803:Blood Transfusion; D036861:Delivery, Obstetric / Q000379:methods; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006400:Hematocrit; D006801:Humans; D007262:Infusions, Intravenous; D007552:Isotonic Solutions / Q000008:administration & dosage; D007749:Labor Stage, Third; D016595:Misoprostol / Q000008:administration & dosage / Q000627:therapeutic use*; D010120:Oxytocics / Q000008:administration & dosage / Q000627:therapeutic use*; D010121:Oxytocin / Q000008:administration & dosage / Q000627:therapeutic use*; D006473:Postpartum Hemorrhage / Q000517:prevention & control*; D011247:Pregnancy; D011446:Prospective Studies; D000077325:Ringer's Lactate
D007552:Isotonic Solutions; D010120:Oxytocics; D000077325:Ringer's Lactate; D016595:Misoprostol; D010121:Oxytocin