A Comparative Study on Sublingual 400 µg Misoprostol and Intravenous 0.2 mg Methylergometrine for Active Management of Third Stage of Labor

The objective of this chapter is to compare the efficacy and side effects of sublingual 400 µg misoprostol with 0.2 mg intravenous methyl- ergometrine in active management of third stage of labor.

In a prospective, randomized comparative study conducted at the Department of Obstetrics and Gynecology, AVBRH, Wardha, 200 full-term pregnant women without high risk factors were examined in two groups of 100 each to determine the safety and effectiveness of 400 mg sublingual misoprostol compared to 0.2 mg intravenous methylergometrine at the delivery of the anterior shoulder from December 2010 to November 2011.

The findings showed that Mean duration of third stage in misoprostol group was 9.67 ± 1.98 min, amount of blood loss was 203 ± 24 ml, need of additional uterotonics was 13%, drop in hemoglobin 0.59 ± 0.79 which were almost comparable with other group and side effects were mainly shivering and pyrexia in misoprostol group and vomiting and giddiness in methergine group.

Sublingual 400 µg misoprostol is nearly as effective as intravenous methergine for active management of the third stage of labor, with the added benefit of ease of storage, route of administration, and no risk of injection-associated infections, making it especially useful in rural settings.