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Vol. 63, No. 1, 2007
Issue release date: January 2007
Gynecol Obstet Invest 2007;63:55–60

A Double-Blind Randomized Controlled Trial of Oral Misoprostol and Intramuscular Syntometrine in the Management of the Third Stage of Labor

Ng P.S. · Lai C.Y. · Sahota D.S. · Yuen P.M.
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Background: The aim of this study was to compare the efficacy and safety of oral misoprostol 400 µg with intramuscular syntometrine in the management of the third stage of labor. Material and Methods: This was a double-blind randomized controlled trial conducted in a tertiary care hospital. Three hundred and fifty-five women randomized to receive either oral misoprostol 400 µg or intramuscular syntometrine in the third stage of labor were studied. The change in hemoglobin level from before to 48 h after delivery, use of additional oxytocics and treatment related side effects were the main outcome measures. Results: There were no significant differences between the two groups in terms of the change in hemoglobin level and mean blood loss. The incidence of shivering was significantly higher in the misoprostol group whilst that of vomiting was significantly higher in the syntometrine group. There were no differences in the incidence of nausea, headache, diarrhea and pyrexia between the two groups. Conclusion: Orally administeredmisoprostol at a dose of 400 µg is an acceptable alternative in preventing post-partum blood loss, as measured by the peri-partum change in hemoglobin level and was not associated with an increased incidence of side effects.

Copyright / Drug Dosage

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Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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