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A Double-Blind Randomized Controlled Trial of Oral Misoprostol and Intramuscular Syntometrine in the Management of the Third Stage of Labor

Background: The aim of this study was to compare the efficacy and safety of oral misoprostol 400 µg with intramuscular syntometrine in the management of the third stage of labor. Material and Methods: This was a double-blind randomized controlled trial conducted in a tertiary care hospital. Three hundred and fifty-five women randomized to receive either oral misoprostol 400 µg or intramuscular syntometrine in the third stage of labor were studied. The change in hemoglobin level from before to 48 h after delivery, use of additional oxytocics and treatment related side effects were the main outcome measures. Results: There were no significant differences between the two groups in terms of the change in hemoglobin level and mean blood loss. The incidence of shivering was significantly higher in the misoprostol group whilst that of vomiting was significantly higher in the syntometrine group. There were no differences in the incidence of nausea, headache, diarrhea and pyrexia between the two groups. Conclusion: Orally administeredmisoprostol at a dose of 400 µg is an acceptable alternative in preventing post-partum blood loss, as measured by the peri-partum change in hemoglobin level and was not associated with an increased incidence of side effects.