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Int J Gynaecol Obstet. 2012 Aug;118(2):149-52. doi: 10.1016/j.ijgo.2012.03.038. Epub 2012 Jun 13.

Impact of preoperative rectal misoprostol on blood loss during and after elective cesarean delivery.

Author information

  • Department of Obstetrics and Gynecology, Faculty of Medicine, Alexandria University, Alexandria, Egypt. mervatsheikhelarab@yahoo.com

Abstract

OBJECTIVE:

To evaluate the effect of preoperative administration of rectal misoprostol on blood loss during and after elective cesarean delivery.

METHODS:

A randomized controlled trial was conducted among 400 women scheduled for elective cesarean delivery. The study group (n=200) received 400 μg of misoprostol. The control group (n=200) received placebo. Study medications were administered rectally after catheter insertion and shortly before skin incision. The main outcome measures were intra-operative blood loss, postpartum blood loss at 24 hours, and difference between preoperative and postoperative hematocrit values.

RESULTS:

The mean intra-operative and postpartum blood loss was significantly lower in the study group than the control group: 429 ± 234 mL and 185 ± 95 mL versus 620 ± 375 mL and 324 ± 167 mL, respectively (P=0.001 for both comparisons). The difference between the preoperative and postoperative hematocrit values was also significantly lower in the study group than the control group (4.62 ± 2.45 versus 8.15 ± 3.84; P=0.02). Admissions to the neonatal intensive care unit and Apgar scores at 1 and 5 minutes were comparable between the 2 groups.

CONCLUSION:

Preoperative treatment with 400 μg rectal misoprostol significantly reduced blood loss related to elective cesarean delivery.

Copyright © 2012 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

PMID:
22698700
[PubMed - indexed for MEDLINE]
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