Oral Misoprostol Effective in Preventing Postpartum Hemorrhage

The incidence of postpartum hemorrhage, a leading cause of maternal death, may be decreased by prophylactic use of oxytocics during the third stage of labor. However, these agents must be given intravenously. Recently, oral misoprostol, a prostaglandin E₁ analogue, has been suggested as an alternative. In this study, 1574 women at the start of the third stage of labor were randomized to receive intravenous oxytocin (10 IU) plus oral misoprostol (800 µg, followed by 100 µg at 4 and 8 hours postpartum), oral misoprostol alone, IV oxytocin alone, or IV oxytocin plus intramuscular methylergonovine maleate (0.2 mg).

The incidence of postpartum hemorrhage was 9% with misoprostol alone, 7.3% with oxytocin alone, 3.5% with oxytocin plus methylergono…