A comparative study of efficacy of misoprostol with methyl ergometrine and carboprost in active management of third stage of labour

Background: To assess the efficacy and safety of Misoprostol 800ug per rectally in active management of third stage of labour. Methods: In this prospective study, a total of 200 pregnant women who delivered after 34 weeks of gestation at a tertiary teaching institute were included. The women were divided in to 4 groups by using randomization depending on the drug given at birth of anterior shoulder. Group A were given 800ug of Misoprostol per rectally, Group B were given 0.2mg of methyl ergometrine, Group C were given 125ug of Carboprost and Group D was the control group. The duration of third stage of labor and the blood loss was calculated and the results of all four groups were compared. Results: Out of 200 antenatal women, the average duration of third stage of labor was shortest in the misoprostol group (8.88 minutes).The reduction in blood loss was significant with misoprostol as compared to ergometrine (p=0.016) and carboprost (0.009).The difference in pre and post-delivery hemoglobin was also significantly significant with misoprostol as compared to methyl ergometrine (0.048), carboprost (0.0001) and control (0.006). Conclusions: Misoprostol 800ug per rectally is an effective alternative in the active management of third stage of labor as compared to methyl ergometrine and carboprost.