The use of intramuscular ergometrine at the end of the second stage of normal labour. OXYTOCIC DRUGS IN FOURTH STAGE OF LABOR. A placebo-controlled trial of oral ergometrine to reduce postpartum hemorrhage. The effect of prostaglandin F2 alpha on third stage labor.
nan nan Active management with oral ergometrine 0.4 mg was compared with expectant management for the control of blood loss in the third stage of labor in women at low risk of postpartum hemorrhage (PPH).
                A three-arms randomized trial in which 0.4 mg ergometrine (2 tablets of 0.2 mg) was set off against placebo, both groups allowing comparison with a standard oxytocin regimen of 5 IU. Women at low risk for PPH. Of 367 parturients, 146 were randomised to ergometrine 0.4 mg, 143 to placebo and 78 to intramuscular oxytocin in a 2:2:1 design.
                Compared with placebo, ergometrine reduced blood loss with 5% (-5%; Confidence interval: -20% to +13%). Oxytocin reduced blood loss with 9% (-9%; Confidence interval: -26% to +12%) versus placebo.
                Oral ergometrine has too little effect on blood loss after childbirth in order to be a good alternative to parenteral prophylactic management. The effects of intramyometrially injected PGF2 alpha intravenous Ergometrin and no treatment were compared during 3rd stage labor in 140 patients. In comparison with Ergometrin or no treatment, PGF2 alpha significantly reduced the duration of 3rd stage labor, blood loss, incidence of subinvolution and subfebrility.
Prophylactic intramuscular or intravenous injections of ergot alkaloids are effective in reducing blood loss, postpartum haemorrhage and the use of therapeutic uterotonics, but adverse effects include elevated blood pressure and pain after birth requiring analgesia, particularly with the intravenous route of administration.