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Active Management of the Third Stage of Labor With a Combination of Oxytocin and Misoprostol to Prevent Postpartum Hemorrhage: A Randomized Controlled Trial

Obstet Gynecol. 2016 Oct;128(4):805-11

Editor's comment: Prof. Jim Thornton: The addition of misoprostol to 3rd stage oxytocin does not prevent postpartum haemorrhage

A large, 1,721 participant, randomized controlled trial from France comparing oxytocin plus oral misoprostol with oxytocin alone, for post-partum haemorrhage prophylaxis in the 3rd state of labour was negative.  Rates of moderate and severe bleeding were not reduced, and side effects were significantly higher in the misoprostol group.