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Introduction
Postpartum hemorrhage complicates 4-6% of vaginal deliveries and is
regarded as a major cause of maternal mortality and morbidity, causing
deaths in 25-43% of pregnant women or 20 million deaths each year
worldwide. (1-3)
This calls us to consider measures and interventions to minimize postpartum
hemorrhage. Active treatment of the third stage of labour which includes
early cord clamping, controlled cord traction for placental delivery
and intravenous oxytocin therapy is an effective measure to prevent
postpartum hemorrhage. In our hospital the active management of third
stage of labour is practiced routinely.(4,5)
Recently, oral misoprostol has been used to prevent postpartum hemorrhage.
(6-10) It has many advantages over oxytocin because it is inexpensive
($1.3 for each 200 microgram tablet), heat stable at room temperature
and does not require parenteral administration.
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More recent studies reviewed the use of rectal
misoprostol for the prevention of postpartum hemorrhage, but available
data about the pharmacokinetics of rectal misoprostol and its use
in preventing postpartum hemorrhage are still controversial.
We underwent this study to test the effects of rectal misoprostol
in preventing postpartum hemorrhage compared to oxytocin and to add
to the other measures that help to decrease the incidence of postpartum
hemorrhage.
 
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