Randomised controlled trial in 400 vaginal delivery cases, comparing the efficacy of 600 mcg rectal or oral misoprostol and IM. syntometrine, in minimizing blood loss from uterine atony in the postpartum period.Oral and rectal misoprostol appear to be as effective in minimizing blood loss in the early postpartum period as syntometine. Shivering and pyrexia are more frequent with misoprostol use.