Double-blind randomized controlled trial comparing misoprostol and oxytocin for management of the third stage of labor in a Nigerian hospital.
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Date
2015
Journal Title
Journal ISSN
Volume Title
Publisher
The Journal of the International Federation of Obstetrics and Gynaecology (FIGO)
Abstract
Objective: To compare the efficacy of oral misoprostol with that of oxytocin for active management of the third
stage of labor (AMTSL). Methods: A 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 (600 μg) plus placebo injection or oral
placebo plus oxytocin injection (1 mL of 10 IU) in the third stage of labor. The primary outcome was amount
of blood loss during delivery. Results: Mean postpartum blood loss was 325.85 ± 164.72 mL in the 100 patients
givenmisoprostol and 303.95±163.33 mL 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 b 0.01 for
all). Conclusion: The efficacy of oral misoprostol was similar to that of intramuscular oxytocin. Adverse effects associatedwith misoprostol were transient and self-limiting. Thus, oral misoprostol is efficacious and a good alternative to oxytocin for AMTSL
Description
Keywords
Adverse effects Efficacy, Intramuscular oxytocin, Oral misoprostol, Third stage of labor
Citation
Musa, A.O, Ijaiya M.A, Saidu, R, Aboyeji, A.P, Jimoh, A.A, Adesina K.T& Abdul I.F (2015): Double-blind randomized controlled trial comparing misoprostol and oxytocin for management of the third stage of labor in a Nigerian hospital. International Journal of Gynecology & Obstetrics 129(3); 227-230.