Compare the efficacy and side effects of Misoprostol and Methylergometrine for the Prevention

BACKGROUND: Compare the efficacy and side effects of misoprostol and methylergometrine for the prevention of postpartum haemorrhage in active management of third stage of labour. METHODS AND METHODS: A prospective study was carried out at SSG Hospital Vadodara from January 2011 to May 2012. 200 women with singleton uncomplicated pregnancies between 37-42 weeks were enrolled for the study. Immediately after delivery of baby, all women received three capsules orally and the contents of an ampoule by intravenous injection. The capsules contained either a total of 600 μg misoprostol or placebo or the ampoule 200 μg of methylergometrine or placebo. Main outcomes were duration of third stage of labour, amount of blood loss, need for further uterotonic drugs and the presence of side effects. RESULTS: Duration of third stage of labour was 8.06 minutes with methylergometrine and 11.46 minutes with misoprostol (P<0.001).Postpartum haemorrhage occurred in 1% and 5% women with methylergometrine and misoprostol respectively (P=0.2137).The need for further uterotonic drugs was 1% and 5% after methylergometrine and misoprostol respectively (P= 0.2137). 11% women developed fever (> 38°C) after misoprostol and none after methylergometrine. Shivering occurred in 11% women after misoprostol and in 1% women after methylergometrine. Diarrhoea occurred in 6% women in misoprostol group and in none in the methylergometrine group. Nausea occurred in 9% and 1% with methylergometrine and misoprostol respectively. CONCLUSIONS: This study suggests that although protection from postpartum haemorrhage using parenteral methylergometrine and oral misoprostol is nearly equal, misoprostol is associated with more side effects.