Comparing Intravenous Oxytocin Vs. Rectal Misoprostol for Third-Stage Management after Second-Trimester Medically Induced Abortion

Background: Induction of medical abortion during the second trimester of pregnancy is considered under certain medical conditions. Abortion in the second trimester of pregnancy could be accompanied by several side effects including hemorrhage and placenta retention. Several types of medications including oxytocin, ergots, and prostaglandins are used to control and optimize the third stage of labor and condition of delivery. The aim of this study was to compare the efficacy of intravenous oxytocin versus rectal misoprostol for the management of the third stage of labor during pregnancy termination. Methods: In this randomized clinical trial, 80 pregnant women between 14 to 24 weeks of gestational age were randomly assigned into two intervention groups. Twenty units of intravenous oxytocin was used as the standard regimen and it was compared with 400 μg of rectal misoprostol to manage the third stage of labor.Results: In this study, the frequency of placenta retention was significantly (P=0.034) lower in the misoprostol group (n=3, 7.5%) compared with oxytocin group (n=10, 25%). The average duration of placenta delivery was significantly lower in the misoprostol group (7.95 min Vs. 19.22 min, respectively; P=0.015). Decreases in hemoglobin concentration was not significantly different between the two groups. Conclusion: Generally, management of the third stage of labor in second-trimester abortions could reach a better outcome, regarding lower risks of placenta retention and duration of delivery, if rectal misoprostol is administered instead of intravenous oxytocin.