Azadi Teaching Hospital, Kirkuk


Background Third stage of labour is defined as the time from delivery the baby to complete delivery of the placenta and its attached membranes Most common complications of the third stage of labour are postpartum hemorrhage (PPH). Active management of third stage of labour (AMTL) prevents PPH. Misoprostol is a prostaglandin E1 analogue has been suggested as an alternative of the routine prophylactic oxytocic agents in AMTL. Rectal route had been chosen because it avoids gastrointestinal side effects Objectives: To asses effectiveness of (400 mcg) rectally administered misoprostol tablet in the AMTL in comparison with standard oxytocin regimen Patients and Methods In prospective case-control study, 100 women were randomized, 50 patients received either 400mcg misoprostol tablets rectally (study medication) the other 50 received 10 IU oxytocin in 500 ml Ringer lactate solution IV. As a method of AMTL. Patient with risk factor for PPH had been excluded. A comparison between the two groups in their amount of blood loss, drop in hemoglobin level from admission to 24 hr. after delivery, duration of third stage of labour and any side effects appear done Results Maximum amount of blood loss in both groups of the study was 440 ml, so we had no case of PPH. There was no stastically significant difference in mean blood loss, mean difference in Hb level (gm/dl) on admission and 24 hours after delivery, and duration of third stage of labour found between study groups [p values= 0.138, 0.227, 0.08 respectively]. More shivering occurs in cases but the difference was not significant. Conclusions: Misoprostol in a dose of 400 mcg rectally shows promising results, it seems safe and effective drug that can be used in the management of third stage of labour.