Comparison of the efficacy of a combination of Intramuscular Oxytocin (10 IU) and Sublingual Misoprostol(600mcg) with Intramuscular Oxytocin alone for Active Management of the Third Stage of Labour following Singleton Emergency Caesarean delivery - A Randomised, Double-blinded, Placebo-Controlled Trial

Postpartum haemorrhage (PPH) is defined as blood loss of 1000ml or more within 24 hours following a Lower Segment Cesarean Section (LSCS). It nearly affects 5% of the women population giving birth. PPH accounts for about 1/4th of all maternal deaths and is the leading cause of the same. WHO recommendation for the prevention of PPH through Active Management of the Third Stage of Labour (AMSTL) is 10U IM or IV oxytocin immediately following delivery of the baby. In 2018, WHO recommended using oxytocin 10U (IM or IV) and misoprostol (400 or 600 micrograms) to prevent PPH for all births. Injectable prostaglandins are not recommended for preventing PPH. In the setting of oxytocin unavailability and skilled health personnel are not present to administer injectable uterotonics, the administration of Misoprostol (400 or 600 micrograms) by community and lay health workers is recommended

There is a lack of efficacy studies comparing the combination of sublingual misoprostol 600mcg and IM oxytocin 10 IU versus IM oxytocin 10 IU IM for active management of the third stage of labour for singleton emergency caesarean delivery.

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