The efficacy of misoprostol compared with methyl ergometrine for prevention of postpartum hemorrhage: A Prospective Randomized Study

Background: Blood loss of 500 milliliters or more from the vaginal tract following delivery is referred to as postpartum hemorrhage. Even within the usual range, a parturient with severe anaemia may die from hemorrhage. Aim: For the purpose of contrasting the safety and effectiveness of intravenous methyl ergometrine with oral misoprostol in preventing postpartum hemorrhage in women having a normal vaginal birth.Subjects and methods: Over the course of a year, 140 patients from the Obstetrics and Gynecology Department at Al-Azhar University Hospitals in Cairo, Egypt, participated in this prospective randomized controlled trial.Results: The misoprostol group had a significantly higher proportion of primigravid patients (54.3% vs 35.7%, p=0.021), which is clinically relevant as primigravidity is associated with increased risk of PHH and different uterine contractility patterns. The incidence of blood loss>500mL was similar between groups (17.1% vs 21.4%, p=0.33), as was severe hemorrhage>1000mL (1.4% vs 1.4%, p=0.75).Conclusion: The 400μg sublingual misoprostol is as effective as 200μg intravenous methylergonovine for preventing PHH, with comparable safety profiles. The equivalent efficacy, combined with misoprostol's practical advantages in terms of stability, route of administration, and cost, supports its use as a viable alternative to methylergonovine for PHH prevention.