Clinical Investigation

Evaluation of the efficacy of rectal misoprostol versus intravenous oxytocin for the prevention of postpartum hemorrhage

  • Özlem Kemik Gül
  • Asli Somunkiran
  • Ismail Özdemir
  • Oguz Yücel
  • Fuat Demirci

Turk J Obstet Gynecol 2006;3(3):162-166

OBJECTIVE: To compare the effectiveness of rectally administered prostaglandine E1 anolog misoprostol and parenterally oxytocin for the prevention of postpartum hemorrhage. Design: Prospective randomized trial Setting: University hospital Patients: 240 full term pregnant women who were in active labor. Interventions: 80 patients in group 1 received 200 μg misoprostol rectally, 80 patients in Group 2 received 400 μg rectally misoprostol, and the third group received a solution of 1000 ml 5% DRL + 10 IÜ oxytocin, immediately after the delivery of the fetus. Main outcome measures: Postpartum blood loss and potential side effects of misoprostol were evaluated. RESULTS: No statistically significant difference was found among the three groups regarding the average blood loss (F=1.50, p=0.22). Average duration of the third stage of labor was similar in all groups (F=1.13, p=0.32). Hematocrit values were similar in the groups both before (F=3.28, p=0.52) and after the delivery and (F=1.84, p=0.16). CONCLUSIONS: No differences were found between rectally misoprostol and oxytocin treatment for the prevention of postpartum hemorrhage. Nevertheless, misoprostol can be preferred in the prevention of postpartum hemorrhage because it does not require special storage conditions, can be used safely in hypertensive patients, can be stored for many years, it is resistant to heat and its side effects such as nausea and vomiting are low when used rectally.

Keywords: misoprostol, oxytocin, postpartum hemorrhage