The third stage of labor is the most crucial stage of labor as in it lurks more unheralded treachery than in the first two stages combined. It carries with it the potential dangers like postpartum hemorrhages, retention of placenta, shock, pulmonary embolism and uterine inversion. 200 cases of vaginal deliveries conducted in Government General Hospital, Kakinada, were studied from November 2013 to October 2014. The current study is aimed at determining the efficacy of 400micrograms of misoprostol (PGE1) when given sublingually at the birth of anterior shoulder, in comparison with 200 micrograms (0.2mg) of intravenous methyl ergometrine, in the active management of third stage of labor, in reducing the third stage of blood loss and in reducing the risk of atonic postpartum hemorrhage. The patients were divided in two groups, 100 for each treatment regimen, misoprostol group and methyl ergometrine group. In all the groups majority of the patients both primis and second gravidas were in 21-25 years age groups Majority of the primis and secondgravidas were in 39-40 weeks gestational age. The mean duration of 3rd stage in misoprostol group was 3.52±1.11 mins.and in methyl ergometrine group was 6.58±213min.P value0.001.whic is statistically significant. The mean total third stage blood loss which includes the blood loss at delivery and the blood loss up to 1hr of postpartum period was 86.85cc in the misoprostol group and that in the methylergometrine group was 161.63cc. Misoprostol can be routinely used instead of methylergometrine for more effective management of third stage of labor. As misoprostol was easier to administer and safe, it is an acceptable alternative available other uterotonincs which are in use for the third stage of labor and management of PPH.
