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Results: Obstetrics & Gynecology 

(C) 2005 The American College of Obstetricians and Gynecologists

Volume 105(4) Supplement, April 2005, p 39S

Prophylactic Use of Misoprostol in the Third Stage of Labor [Papers on
Current Clinical and Basic Investigation: Poster Sessions: Monday, May 9,
2005: Obstetrics]

Baskett, Thomas F. MB; Persad, Vidia MB; Clough, Heidi RN; Young, David MD
Dalhousie University, Halifax, Nova Scotia, Canada (Baskett)

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Outline

  OBJECTIVE:

  METHODS:

  RESULTS:

  CONCLUSIONS:

OBJECTIVE:

To assess the effectiveness of oral misoprostol in comparison with
intravenous oxytocin in reducing bleeding during the third stage of labor.

METHODS:

A double-blind, randomized controlled trial comparing oral misoprostol 400
[mu]g and intravenous oxytocin 5 U, given after delivery of the anterior
shoulder of the fetus, was performed. The primary outcome was a hematocrit
drop greater than 10% at 24 hours postpartum. Secondary outcomes included
hemoglobin drop greater than 30%, need for additional oxytocics, blood loss
greater than 1,000 mL, manual removal of placenta, blood transfusion, and
the adverse effects of shivering and fever.

RESULTS:

Results for the intravenous oxytocin (n = 311) and oral misoprostol (n =
311) groups are as follows (expressed as percentages of each group):
hematocrit drop greater than 10%, 3.4% and 3.7%, respectively (P = NS);
hemoglobin greater than 30%, 8.9% and 10.2%, respectively (P = NS); blood
loss greater than 1,000 mL, 2.3% and 4.5%, respectively (P = NS); manual
removal of placenta, 8.0% and 8.0%, respectively (P = NS); additional
oxytocics, 40.5% and 51.1%, respectively (P P P 

CONCLUSIONS:

Oral misoprostol is as effective as intravenous oxytocin in reducing loss at
delivery but is associated with an increased need for additional oxytocic
drugs. The adverse effects of shivering and fever were only present with
misoprostol but were not clinically troublesome.Accession Number:
00006250-200504001-00088


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