• Renu Tewatia, Shikha Rani, Usha Srivastav, and Bela Makhija.
• Department of Obstetrics and Gynecology, Government Medical College and Hospital, Chandigarh, India.
• Arch. Gynecol. Obstet. 2014 Apr 1; 289 (4): 739-42.

BackgroundPost-partum hemorrhage (PPH) is the most common direct cause of maternal mortality and timely intervention can save many lives.ObjectiveTo compare the effectiveness of sublingual misoprostol to intravenous oxytocin in preventing post-partum hemorrhage in low risk vaginal birth.MethodsOne hundred patients with no risk factor for PPH were randomly allocated to receive 600 μg misoprostol administered sublingually or 10 IU of intravenous oxytocin immediately after the delivery of baby. Main outcome measures were post-partum blood loss, drop in hemoglobin in 24 h, duration of third stage of labor, and drug-related adverse effects.ResultsMean age, parity and gestational age were similar in both groups. Mean blood loss was significantly lower in oxytocin group (114.28 ± 26.75 versus 149.50 ± 30.78 ml; p = 0.00). Drop in hemoglobin was 0.31 ± 0.16 versus 0.49 ± 0.21 g% (p = 0.01) in oxytocin and misoprostol group, respectively. Duration of third stage labor was shorter in oxytocin group (median 5 min, IQR: 4.5-5.5 versus 5.5 min, IQR: 5-6 min, p < 0.01). Although fever and shivering were common adverse effects with misoprostol but were not clinically significant.ConclusionIntravenous oxytocin is more efficacious than sublingual misoprostol in preventing PPH in institutional deliveries.

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