A comparative study of methylergonovine and 15-methyl prostaglandin F2α in active management of third stage of labor

OBJECTIVE Postpartum hemorrhage is most common cause of maternal mortality. Active management of third stage of labor minimizes the risk of postpartum hemorrhage. To compare the effect of methylergonovine and 15-methyl prostaglandin F2α (15-methyl PGF2α) in active management of third stage of labor. METHODS A randomized open labelled parallel study with 50 women in normal labor, 25 in each group were included. The drugs methylergonovine (0.2 mg) intravenous and 15-methyl PGF2α (250 µg) intramuscular were administered at the time of delivery of anterior shoulder. Main outcomes measured were amount of blood loss during the first four hours of delivery and objective measurement of hemoglobin and hematocrit levels before delivery and third day postpartum. RESULTS There was no statistically significant difference in the blood loss between the two groups at delivery (P = 0.130), at 1 hour of delivery (P = 0.453). The blood loss with 15-methyl PGF2α was significantly less as compared to that of blood loss with methylergonovine at four hours of delivery (P = 0.014) and the total, i.e., during first four hours, amount of blood loss was significantly less with 15-methyl PGF2α (P = 0.026). There was no statistically significant difference in the hemoglobin and hematocrit levels measured predelivery and postpartum third day between both the drugs. CONCLUSION Both the drugs were effective in controlling the amount of blood loss during the third stage of labor, 15-methyl PGF2α being more efficacious.