Misoprostol for the Prevention of Postpartum Hemorrhage in Rural Pakistan

A Placebo-Controlled Randomized Trial of Misoprostol in the Management of the Third Stage of Labor in the Home Delivery Setting in Rural Pakistan

This community-based trial will study misoprostol for the prevention of postpartum hemorrhage in rural Pakistan. Traditional birth attendants assisting home deliveries will administer study tablets (600 mcg oral misoprostol or placebo) in the third stage of labor to women participating in the trial. Blood loss, hemoglobin levels, side effects, and other variables will be evaluated.

Inclusion Criteria:

• Pregnant women in general good health, home delivery
• Must live in one of 78 study villages

Exclusion Criteria:

• Hypertension
• Non-cephalic presentation
• Polyhydramnios
• Previous cesarean section
• Suspected multiple pregnancy
• Suspected still birth
• Antepartum hemorrhage
• Previous complication in 3rd trimester
• Anemia of <8 g/dl