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Objective To investigate the use of the oral prostaglandin E1 analogue, misoprostol in the prevention of postpartum haemorrhage.

Design A prospective observational study.

Setting A university teaching hospital.

Participants Two hundred and thirty-seven consecutive women undergoing vaginal delivery.

Methods All the women were given 600 μg oral misoprostol just after delivery.

Main outcome measures Rates of postpartum haemorrhage; need for therapeutic oxytocic drugs; retained placenta and length of the third stage of labour.

Results Postpartum haemorrhage occurred in 6% of the women; the need for therapeutic oxytocics in 5%, retained placenta in 2% and the median length of the third stage was 5 min. Vomiting and diarrhoea in the first hour after delivery occurred in 8% and 3% respectively and shivering in 60%.

Conclusions Misoprostol may be effective in the prevention of postpartum haemorrhage, and has few side effects. A double blind randomised trial is required.