Comparison of sublingual misoprostol with intramuscular oxytocin in active management of the third stage of labor

Background: Postpartum hemorrhage (PPH) is the most common cause of maternal mortality worldwide. Significant numbers are preventable, especially in low-resource settings. Active management of the third stage of labor (AMTSL) is a key denominator. The present study aimed to compare sublingual misoprostol with intramuscular oxytocin in AMTSL to search for an easy and effective alternative for low-resource settings. Materials and Methods: A prospective randomized comparative study was conducted, where the subjects were registered over 1 year extending from May 2020 to June 2021 including 200 patients admitted to the labor room with term pregnancy with a period of gestation between 37 and 42 weeks and were divided into two groups, Group A and Group B receiving intramuscular oxytocin and sublingual misoprostol, respectively. Results: Sublingual misoprostol was equally effective compared with intramuscular oxytocin in the prevention of PPH. There were no statistical differences in the duration of the third stage of labor, need for additional uterotonics, need for manual removal of placenta, and need for blood transfusion in the two groups. Conclusion: Sublingual misoprostol appeared to be as effective as intramuscular oxytocin in the AMTSL and may be an alternative, especially in low-resource settings.