Mervat S-E-A Elsedeek1. 1. 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 lossduring 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.
RCT Entities:
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.
Authors: Mohamed A Shalaby; Ahmed M Maged; Amira Al-Asmar; Mohamed El Mahy; Maged Al-Mohamady; Nancy Mohamed Ali Rund Journal: BMC Pregnancy Childbirth Date: 2022-03-14 Impact factor: 3.007
Authors: Ioannis D Gallos; Helen M Williams; Malcolm J Price; Abi Merriel; Harold Gee; David Lissauer; Vidhya Moorthy; Aurelio Tobias; Jonathan J Deeks; Mariana Widmer; Özge Tunçalp; Ahmet Metin Gülmezoglu; G Justus Hofmeyr; Arri Coomarasamy Journal: Cochrane Database Syst Rev Date: 2018-04-25