Background: To compare the efficacy of oxytocin, methylergometrine and misoprostol in active management of third stage of labour (AMTSL).Methods: A clinical study was conducted on 330 low risk pregnant women with a healthy singleton pregnancy and spontaneous onset of labour at term; allocated into three groups where active management of third stage of labour was done with either Oxytocin 10 IU intramuscular, or Methylergometrine 0.2 mg intramuscular, or tab Misoprostol 600µg sublingual on 110 women each group. Primary parameter was blood loss during labour. Secondary parameters were the duration of third stage of labour and changes in haemoglobin level.Results: Blood loss during labour in Oxytocin group was 145.86±11.53 ml, which was significantly less than that in Methylergometrine (164.02±9.36 ml) and Misoprostol groups (183.18±9.70 ml), but no patient in any of the groups had blood loss more than 200ml. Duration of third stage of labour was significantly less in Oxytocin group (5.13±1.91 mins) than in. Methylergometrine (6.16±1.85 mins), and Misoprostol groups (6.47±1.51 mins). No patient had prolonged third stage in any of the groups. There was no significant change in pre-and post-delivery haemoglobin levels in all the groups.Conclusions: Though injectable uterotonics are effective for active management of third stage of labour (AMTSL), misoprostol can also be effectively used, especially in settings where there is no adequate trained personnel and drug storage facility.

Background: Childbirth is one of the most wonderful and anticipated moments in a woman’s life. But the excruciating pain associated with labour makes it a really undesirable one. Objective of present study was to compare the effects of programmed labour protocol and expectant management of labour.Methods: A clinical study was conducted on 120 low risk primigravida, 60 of them were managed with programmed labour protocol (group A) and the rest 60 (group B) were managed expectantly. Primary parameters were pain relief and changes in the mean duration of labour. Secondary parameters were changes in the amount of blood loss and APGAR score of delivered babies.Results: Among group A, 25% had good pain relief, 60% had moderate pain relief, 15% had mild pain relief and 0% had no relief of pain. The mean duration of labour from active phase through third stage in group A was 234.27±50.38 minutes and 304.58±41.72 minutes in group B. The average blood loss during labour was 89.33±19.06 ml in group A and 142.15±32.27 ml in group B. In group A, 4 babies had APGAR score less than 7 at 1 minute, but had score more than 7 after 5 minutes following resuscitation. In group B, 9 babies had APGAR less than 7 at 1 minute. Of these, 6 babies had score more than 7 after 5 minutes following resuscitation. 3 babies had score less than 7 even after 5 minutes and were shifted to neonatal ICU.Conclusions: Programmed labour protocol is an effective method to reduce the deleterious effects of labour on both mother and foetus.