الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
The primary aim of this study is to evaluate the efficacy of the misoprostol when be administrated in the same dosage (600 mcg) and via different routes of administration (oral, sub-lingual, oral solution and rectal) in the active management of the third stage of labour versus oxytocin (in 10 IU), A traditional pharmacological drug given routinely in the of labour. The secondary aim is to evaluate the safety (common side-effects) of these drugs when used in the active management of the third stage of labour.
Conclusion:
Misoprostol is inexpensive, easily stored, easily administrated and effective uterotonic agent has many indications in obstetrics. One of its important indications is its use in the active management of the third stage of labour, as a prophylaxis against PPH.
The route of administration affecting significant the efficacy and safety of misoprostol. Oral solution and sublingual routes promise to be the most effective ways of administration, resulting in the fastest onset of action, strongest uterotonic effects and associated with lower amount of postpartum bleeding, lower incidence of PPH, lower incidence of need for traditional ecobolics and blood transfusion. Thus their use as an alternative to the conventional oxytocics in the active management of the third stage of labour is acceptable especially in the developing countries.
Also these routes may lead to better delivery outcomes as reduce incidence of PPH and postpartum anaemia that can increase the incidence of postpartum pyrexia and infection.
The incidence of side effects, especially shivering and pyrexia is higher in oral solution and sublingual routes due to the higher peak plasma concentrations of misoprostol acid achieved by these routes, while GIT symptoms more frequent with oral route. These side effects are usually mild and self-limiting; however, they can occasionally be severe but easy to be managed.