Sublingual 400 μg Misoprostol vs Intravenous 0.2 mg Methylergometrine for Active Management of Third Stage of Labor

Abstract

Objectives: To compare the efficacy and side effects of sublingual 400 µg misoprostol with 0.2 mg intravenous methylergometrine in active management of third stage of labor. Materials and methods:In a prospective, randomized comparative study conduted in Department of Obstetrics and Gynecology, AVBRH, Wardha, 200 women at full-term gestation, without any high risk factors were studied in two groups of 100 each, for safety and efficacy of 400 µg sublingual misoprostol in comparison to 0.2 mg intravenous methylergometrine at the delivery of anterior shoulder from December 2010 to November 2011. Main parameters used were duration of 3rd stage, amount of blood loss, need of aditional uterotonic, complications of third stage, drop in hemoglobin and side effects. Results were analyzed by Student's t-test.Results: Mean duration of third stage in misoprostol group was 9.67 ± 1.98 min, amount of blood loss was 203 ± 24 ml, need of additional uterotonics was 13%, drop in hemoglobin 0.59 ± 0.79 which were almost comparable with other group and side effects were mainly shivering and pyrexia in misoprostol group and vomiting and giddiness in methergine group. Conclusion:Sublingual 400 µg misoprostol is almost equally effective as intravenous methergine for active management of third stage of labor with advantage of simplicity of storage of drug, route of administration and no risk of injection associated infections, which make it very much relevant in rural scenario.