title: Double-blind randomized controlled trial comparing misoprostol and oxytocin for management of the third stage of labor in a Nigerian hospital.
abstract: OBJECTIVE
  To compare the efficacy of oral misoprostol with that of oxytocin for active management of the third stage of labor (AMTSL).
  
  
  METHODS
  A double-blind randomized control trial was undertaken at a center in Ilorin, Nigeria, between January and June 2013. Every other eligible patient (in the first stage of labor at term, to have a spontaneous vaginal delivery, and no/low risk of postpartum hemorrhage [PPH]) were randomly assigned with computer-generated random numbers to receive oral misoprostol (600μg) plus placebo injection or oral placebo plus oxytocin injection (1mL of 10IU) in the third stage of labor. The primary outcome was amount of blood loss during delivery.
  
  
  RESULTS
  Mean postpartum blood loss was 325.85±164.72mL in the 100 patients given misoprostol and 303.95±163.33mL in the 100 patients given oxytocin (P=0.391). PPH (≥500mL blood loss) was recorded in 15 (15.0%) patients given misoprostol and 14 (14.0%) given oxytocin (P=0.841). Shivering, pyrexia, and diarrhea were all significantly more common in the misoprostol group (P<0.01 for all).
  
  
  CONCLUSIONS
  The efficacy of oral misoprostol was similar to that of intramuscular oxytocin. Adverse effects associated with misoprostol were transient and self-limiting. Thus, oral misoprostol is efficacious and a good alternative to oxytocin for AMTSL. Pan African Clinical Trials Registry:PACTR201407000825227.
authors.affiliation: Department of Obstetrics and Gynecology, Federal Medical Centre, Lokoja, Nigeria.
authors.forename: Abdulkarim O
authors.initials: AO
authors.lastname: Musa
authors.affiliation: Department of Obstetrics and Gynecology, University of Ilorin/University of Ilorin Teaching Hospital, Ilorin, Nigeria. Electronic address: munirijaiya@yahoo.com.
authors.forename: Munir'deen A
authors.initials: MA
authors.lastname: Ijaiya
authors.affiliation: Department of Obstetrics and Gynecology, University of Ilorin/University of Ilorin Teaching Hospital, Ilorin, Nigeria.
authors.forename: Rakiya
authors.initials: R
authors.lastname: Saidu
authors.affiliation: Department of Obstetrics and Gynecology, University of Ilorin/University of Ilorin Teaching Hospital, Ilorin, Nigeria.
authors.forename: Abiodun P
authors.initials: AP
authors.lastname: Aboyeji
authors.affiliation: Department of Obstetrics and Gynecology, University of Ilorin/University of Ilorin Teaching Hospital, Ilorin, Nigeria.
authors.forename: Abiodun A
authors.initials: AA
authors.lastname: Jimoh
authors.affiliation: Department of Obstetrics and Gynecology, University of Ilorin/University of Ilorin Teaching Hospital, Ilorin, Nigeria.
authors.forename: Kikelomo T
authors.initials: KT
authors.lastname: Adesina
authors.affiliation: Department of Obstetrics and Gynecology, University of Ilorin/University of Ilorin Teaching Hospital, Ilorin, Nigeria.
authors.forename: Ishaq F
authors.initials: IF
authors.lastname: Abdul
mesh_terms: D000284:Administration, Oral; D000328:Adult; D001810:Blood Volume; D003967:Diarrhea / Q000139:chemically induced; D004311:Double-Blind Method; D005260:Female; D005334:Fever / Q000139:chemically induced; D006761:Hospitals; D006801:Humans; D007273:Injections, Intramuscular; D007749:Labor Stage, Third; D016595:Misoprostol / Q000008:administration & dosage* / Q000009:adverse effects; D009549:Nigeria; D010120:Oxytocics / Q000008:administration & dosage* / Q000009:adverse effects; D010121:Oxytocin / Q000008:administration & dosage* / Q000009:adverse effects; D006473:Postpartum Hemorrhage / Q000517:prevention & control*; D011247:Pregnancy; D012768:Shivering; D055815:Young Adult
chemical_list: D010120:Oxytocics; D016595:Misoprostol; D010121:Oxytocin
keywords: Adverse effects; Efficacy; Intramuscular oxytocin; Oral misoprostol; Third stage of labor