Document Type : Original Article
Authors
1
Assistant Professor, Department of Obstetrics and Gynecology, Reproductive Health Research Center, Faculty of Medicine, Guilan University of Medical Sciences, Rasht, Iran.
2
Resident of Obstetrics and Gynecology, Reproductive Health Research Center, Faculty of Medicine, Guilan University of Medical Sciences, Rasht, Iran.
3
Assistant Professor, Department of Epidemiology, Reproductive Health Research Center, Faculty of Medicine, Guilan University of Medical Sciences, Rasht, Iran.
4
Medical Student, Reproductive Health Research Center, Faculty of Medicine, Guilan University of Medical Sciences, Rasht, Iran.
5
General Practitioner, Reproductive Health Research Center, Faculty of Medicine, Guilan University of Medical Sciences, Rasht, Iran.
Abstract
Introduction: Hemorrhage of the third stage of labor is a major cause of maternal mortality in the world. Oxytocin is the first and standard treatment for postpartum hemorrhage however recently misoprostol as a synthetic analog of prostaglandin E1 is getting more attention. The aim of this study was to compare the effect of sublingual misoprostol and intravenous oxytocin in management of the third stage of labor.
Methods: This double blind randomize controlled trial study was conducted on 200 nulliparous pregnant women who referred to Alzahra hospital of Rasht from 2010 to 2011. Samples were divided into two groups (100 women in each group). The first group was treated with 400 μg sublingual misoprostol and 4 cc normal saline (as a placebo) and another group was treated with 20 IU intravenous oxytocin and two sublingual tablets, as placebo. Data were analyzed by SPSS software version 17, independent t-test and chi-square test. P value less than 0.05 was considered statistically significant.
Results: The mean age of women was 22 ± 4.7 years. The mean postpartum hemorrhages in the plastic bag under the patients and duration of third stage of labor were significantly greater in oxytocin group than misoprostol (p<0.05). The rate of complications was significantly greater in misoprostol group (p=0.005), but hemoglobin changes before and after delivery showed no significant difference in two groups (p=0.06).
Conclusion: Misoprostol is more effective than oxytocin in control of hemorrhage. Therefore, it is recommended to use sublingual misoprostol to reduce postpartum hemorrhage.
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