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Efficacy and safety of perrectal 400 microgram misoprostol versus intravenous 200 microgram methylergometrine in the management of third stage of labor for prevention of postpartum haemorrhage

Background: Objective: Postpartum haemorrhage (PPH) is a major cause of mortality and morbidity during childbirth, especially in developing countries. Misoprostol is a cheap, safe, widely available, and stable at room temperature, does not required any intravenous accesses and having few mild side effects. In resource-poor countries with limited facilities, misoprostol may be one of the important interventions to prevent PPH. We aimed to assess the effectiveness of perrectal low dose misoprostol for the prevention of PPH. Method: We designed a prospective randomized control trial, single centre study. 138  indoor low risk pregnant women with gestational age at least 37 weeks who anticipated vaginal delivery were randomly assigned to perrectal 400 microgram misoprostol  (n = 71) or intravenous 200 microgram (n = 67) methylergometrine after delivery of baby and placenta. The primary outcome was incidence of PPH (estimated blood loss >500 ml after delivery of baby and placenta). Results: In this study out of 138 low risk pregnancy, no women developed PPH, no patient required additional dose of oxytocin, no patient required any form of transfusion.