Background: The third stage of labor is that period
from birth of the infant until the delivery of the
placenta. Active management of the third stage of
labor plays an important role in reducing maternal
morbidity and mortality. Oxytocin is an effective
drug in preventing postpartum hemorrhage (PPH)
however; it requires a controlled environment
and intramuscular administration.Misoprostol is
an orally active uterotonic agent,stable at room
temperature.The purpose of this study was to
compare the efficacy of misoprostol with oxytocin
in active management of third stage of labor.

Materials and Methods: This was a hospital
based study carried out in Paropakar Maternity
and Women Hospital, Kathmandu, Nepal during
six months period from February 2012 to July
2012. One hundred patients fulfilling inclusion
criteria were recruited to receive either 10 unit of
IM oxytocin or 600 mcg of oral misoprostol for the
management of the third stage of labor.

Results: The mean blood loss in misoprostol and
oxytocin group was 209±76.7ml and 197±68.8
ml respectively with p value-0.41 which was
insignificant. Similarly mean hemoglobin change
was also not significant. The additional uterotonics
needed in misoprostol was higher (9 cases) than that
in oxytocin (5 cases) but it was also not significant.
Shivering and fever were significantly high among
misoprostol group than in oxytocin group.

Conclusion: Efficacy of oxytocin and misoprostol
is equal in active management of third stage of labor.


Keywords: misoprostol, oxytocin, postpartum hemorrhage