title: Sublingual misoprostol versus intravenous oxytocin in prevention of post-partum hemorrhage.
abstract: BACKGROUND
  Post-partum hemorrhage (PPH) is the most common direct cause of maternal mortality and timely intervention can save many lives.
  
  
  OBJECTIVE
  To compare the effectiveness of sublingual misoprostol to intravenous oxytocin in preventing post-partum hemorrhage in low risk vaginal birth.
  
  
  METHODS
  One hundred patients with no risk factor for PPH were randomly allocated to receive 600 μg misoprostol administered sublingually or 10 IU of intravenous oxytocin immediately after the delivery of baby. Main outcome measures were post-partum blood loss, drop in hemoglobin in 24 h, duration of third stage of labor, and drug-related adverse effects.
  
  
  RESULTS
  Mean age, parity and gestational age were similar in both groups. Mean blood loss was significantly lower in oxytocin group (114.28 ± 26.75 versus 149.50 ± 30.78 ml; p = 0.00). Drop in hemoglobin was 0.31 ± 0.16 versus 0.49 ± 0.21 g% (p = 0.01) in oxytocin and misoprostol group, respectively. Duration of third stage labor was shorter in oxytocin group (median 5 min, IQR: 4.5-5.5 versus 5.5 min, IQR: 5-6 min, p < 0.01). Although fever and shivering were common adverse effects with misoprostol but were not clinically significant.
  
  
  CONCLUSIONS
  Intravenous oxytocin is more efficacious than sublingual misoprostol in preventing PPH in institutional deliveries.
authors.affiliation: Department of Obstetrics and Gynecology, Government Medical College and Hospital, Chandigarh, India.
authors.forename: Renu
authors.initials: R
authors.lastname: Tewatia
authors.forename: Shikha
authors.initials: S
authors.lastname: Rani
authors.forename: Usha
authors.initials: U
authors.lastname: Srivastav
authors.forename: Bela
authors.initials: B
authors.lastname: Makhija
mesh_terms: D000286:Administration, Sublingual; D000328:Adult; D036861:Delivery, Obstetric; D005260:Female; D005334:Fever / Q000139:chemically induced; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007262:Infusions, Intravenous; D007749:Labor Stage, Third; D016595:Misoprostol / Q000008:administration & dosage* / Q000009:adverse effects; D010120:Oxytocics / Q000008:administration & dosage* / Q000009:adverse effects; D010121:Oxytocin / Q000008:administration & dosage*; D006473:Postpartum Hemorrhage / Q000517:prevention & control*; D011247:Pregnancy; D011446:Prospective Studies; D012768:Shivering; D013997:Time Factors
chemical_list: D006454:Hemoglobins; D010120:Oxytocics; D016595:Misoprostol; D010121:Oxytocin