• Abdulkarim O Musa, Munir'deen A Ijaiya, Rakiya Saidu, Abiodun P Aboyeji, Abiodun A Jimoh, Kikelomo T Adesina, and Ishaq F Abdul.
• Department of Obstetrics and Gynecology, Federal Medical Centre, Lokoja, Nigeria.
• Int J Gynaecol Obstet. 2015 Jun 1; 129 (3): 227-30.

ObjectiveTo compare the efficacy of oral misoprostol with that of oxytocin for active management of the third stage of labor (AMTSL).MethodsA 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.ResultsMean 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).ConclusionThe 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.Copyright © 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

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