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- Title
Comparison of sublingual misoprostol, intravenous oxytocin, and intravenous methylergometrine in active management of the third stage of labor
- Authors
Singh, Gunjan; Radhakrishnan, Gita; Guleria, Kiran
- Abstract
Abstract: Objective: To compare the efficacy and adverse effects of sublingual misoprostol, intravenous oxytocin, and intravenous methylergometrine in active management of the third stage of labor (AMTSL). Methods: A double-blind randomized trial of 300 women with a healthy singleton pregnancy allocated into 4 groups to receive either: 400 µg or 600 µg of sublingual misoprostol, 5 IU of intravenous oxytocin, or 200 µg of intravenous methylergometrine. The primary outcome measure was blood loss in the third and fourth stage of labor; secondary measures were duration of the third stage of labor, changes in hemoglobin levels, and adverse effects. Results: Patients who received 600 µg of misoprostol had the lowest blood loss (96.05±21.1 mL), followed by 400 µg of misoprostol (126.24±49.3 mL), oxytocin (154.7±45.7 mL), and methylergometrine (223.4±73.7 mL) (P <0.01). Shortest mean duration of the third stage of labor (5.74 minutes) was with 600 µg of misoprostol, while methylergometrine had the longest (6.83 minutes) (P <0.05). Pyrexia was observed in the misoprostol groups, and raised blood pressure in the methylergometrine group (P <0.001). The 24-hour postpartum hemoglobin level was similar among the groups (P >0.05). Conclusion: Administration of 600 µg of sublingual misoprostol was more effective than 400 µg of misoprostol, intravenous oxytocin, and intravenous methylergometrine for AMTSL.
- Subjects
MISOPROSTOL; OXYTOCIN; INTRAVENOUS therapy; COMPARATIVE studies; LABOR (Obstetrics); DRUG efficacy; CLINICAL trials; PHARMACODYNAMICS; HEMORRHAGE prevention; PUERPERAL disorders; BLOOD pressure; DOSE-effect relationship in pharmacology; FEVER; HEMOGLOBINS; RESEARCH methodology; MEDICAL cooperation; PUERPERIUM; RESEARCH; TIME; EVALUATION research; RANDOMIZED controlled trials; BLIND experiment; OXYTOCICS; ERGOMETRINE; SUBLINGUAL drug administration; PREVENTION; THERAPEUTICS
- Publication
International Journal of Gynecology & Obstetrics, 2009, Vol 107, Issue 2, p130
- ISSN
0020-7292
- Publication type
journal article
- DOI
10.1016/j.ijgo.2009.06.007