Sublingual Misoprostol Investigated for Enhanced Postpartum Hemorrhage Prevention Alongside Standard AMTSL

Postpartum haemorrhage (PPH) remains the leading cause of maternal mortality globally, accounting for a significant proportion of childbirth-related deaths. Despite the widespread implementation of active management of the third stage of labor (AMTSL), a substantial number of parturients, ranging from 3% to 16.5%, still experience PPH. This persistent challenge underscores the critical need for more effective and accessible uterotonic agents. Misoprostol, a synthetic prostaglandin E1 analogue, has emerged as a promising candidate due to its potent ability to induce uterine contractions. Pharmacokinetic studies have demonstrated that sublingual administration of misoprostol offers superior bioavailability compared to oral or vaginal routes, making it an attractive option for rapid and efficient PPH prevention, especially in settings where intravenous access or refrigeration for oxytocin may be limited.