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Abstract
The maternal mortality ratio is an important reflection of the prenatal, natal and postnatal care in every country. Maternal morbidity and mortality have different causes and their identification is the first Step to avoid some and to manage the others.
The maternal mortality ratio is very low in industrialized countries in comparison to the developing countries where it is very high for example in Egypt; it mounts 174/100,000 live births. The most important leading causes are bleeding, pregnancy - induced hypertension, puerperal sepsis, prolonged labor and abortion.
As postpartum hemorrhage is the most important leading cause of maternal death so, it is recommended to use the uterotonic agents rbutinely in the management of third stage of labor. While, in developing countries we face the problem of transfer of the parturient to the nearest health-care unit and hence the routine use of methyl ergometrine after childbirth but it is associated with side effects as Hypertension and the search for another drug has started.
In these circumstances, the prostaglandins appeared as a hopeful alternative üterotonic. PGE2 and PGF2, come in first consideration. Being rapidly metabolized, the use of prostaglandin analogue (15-methyl) was the way to delay its metabolism and prolong its half-life, but unfortunately, it is associated with gastrointestinal effects as nausea, vomiting, diarrhea, shivering and pyrexia. And these effects were severe enough to stop using the drug.