Objective: to compare the effects on the third stage of labor of umbilical vein injection of 600 mcg misoprostol dissolved in 30 cc saline and 10 IU of oxytocin diluted in 500 cc saline as an intravenous drip.
Patients and Methods: A prospective randomized study was conducted on 1365 women with singleton pregnancy undergoing vaginal delivery at 37 to 41 weeks of gestation in the period from November 2013 to February 2014. In the third stage they were randomized to be given 10 IU of oxytocin diluted in 500 cc saline as an intravenous drip with the delivery of the anterior shoulder or 600 mcg misoprostol dissolved in 30 cc saline injected in the umbilical vein immediately after clamping the cord by the Pipengas technique. The duration of the third stage, amount of blood loss, the incidence of retained placenta and the need for manual removal, hemoglobin and hematocrite levels before labor and 24 hours postpartum and side effects were compared in both groups.
Results: intraumbilical 600 mcg misoprostol was better than 10 IU oxytocin intravenous drip in terms of statistically significant shorter mean duration of third stage of labor (P<0.05), significantly lower incidence of retained placenta and manual removal of the placenta under anesthesia (P<0.05) and also, a significantly less amount of blood loss (P<0.05). There were no significant differences in the rate of adverse effects among both groups.
Conclusion: intraumbilical misoprostol in a dose of 600 mcg was more effective than intravenous drip of 10 IU oxytocin diluted in 500 cc saline in management of the third stage of labor, with a rate of adverse effects similar to that of 10 IU oxytocin intravenous drip.