Misoprostol is currently available in Canada in tablet form and is approved for use for the prevention of treatment and prevention of NSAID- induced gastroduodenal ulcers and the treatment of duodenal ulcers, but not as a uterotonic agent.5 This report with review the evidence of clinical effectiveness of umbilical vein injection with misoprostol for the management of retained placenta and evidenc [...] The other guideline was published in 2009 by the Society of Obstetricians and Gynaecologists of Canada and was focused on the active management of the third stage of labour which included recommendations with respect to umbilical vein injection of misoprostol for the management of retained placenta.3 The NICE guideline followed their standard guideline development methodology, being based upon the [...] A multidisciplinary guidelines working group used a consensus-based approach to developing recommendations.11 The guideline from the Society of Obstetricians and Gynaecologists of Canada was based upon a systematic search of the literature, which captured one additional relevant study from 2007 (outside of the search time frame of this Rapid Response).12 It was stated in the guideline that the evi [...] While the included guideline from the Society of Obstetricians and Gynaecologists of Canada3 clearly identified its intended users and target population, and was based on a systematic search of the literature, the overall quality of the included guideline was difficult to assess as the methodology used to develop the guideline was not included in the publication, aside from a few statements descri [...] In the guideline publication, it was stated that the methodology of the Canadian Task Force on Preventive Health Care (CTFPHC) was followed, but the levels of evidence and strength of recommendation did not appear to align with the current version of the documentation available from the CTFPHC.