Hamideh Pakniat1, Marzieh Beigom Khezri2. 1. Department of Obstetrics and Gynecology, Faculty of Medicine, Qazvin University of Medical Sciences, Shahid Bahonar Ave., PO Box 3419759811, Qazvin, Iran. 2. Department of Anesthesiology, Faculty of Medicine, Qazvin University of Medical Science, Shahid Bahonar Ave., PO Box 3419759811, Qazvin, Iran.
Abstract
PURPOSE: To compare the effect of combined oxytocin-misoprostol versus oxytocin and misoprostol alone in reducing blood lossat cesarean delivery. METHODS:One hundred fifty patients of 18-40 years with singleton term pregnancies scheduled for cesarean section under spinal anesthesia were recruited in a prospective double-blind randomized clinical trial to one of the three following groups to receive 20 IU infusion of oxytocin (group O), 400-µg sublingual misoprostol tablets (group M) or 200-µg misoprostol plus 5 IU bolus intravenous oxytocin (group MO) after delivery. The hemoglobin level before surgery and 24 h after surgery, the need for additional oxytocic therapy, and the incidence of adverse effects were recorded. RESULTS: The mean blood loss during surgery was significantly lower in group MO compared to other groups (P = 0.04). Comparison of mean arterial pressure (P = 0.38) and heart rate (P = 0.23) changes during spinal anesthesia and surgery failed to reveal any statistically significant differences between all groups through repeated measure analysis. CONCLUSION: The use of combined lower dose of misoprostol-oxytocin significantly reduced the amount of blood loss during and after the lower segment cesarean section compared to higher dose of oxytocin and misoprostol alone, and its use was not associated with any serious side effects.
RCT Entities:
PURPOSE: To compare the effect of combined oxytocin-misoprostol versus oxytocin and misoprostol alone in reducing blood loss at cesarean delivery. METHODS: One hundred fifty patients of 18-40 years with singleton term pregnancies scheduled for cesarean section under spinal anesthesia were recruited in a prospective double-blind randomized clinical trial to one of the three following groups to receive 20 IU infusion of oxytocin (group O), 400-µg sublingual misoprostol tablets (group M) or 200-µg misoprostol plus 5 IU bolus intravenous oxytocin (group MO) after delivery. The hemoglobin level before surgery and 24 h after surgery, the need for additional oxytocic therapy, and the incidence of adverse effects were recorded. RESULTS: The mean blood loss during surgery was significantly lower in group MO compared to other groups (P = 0.04). Comparison of mean arterial pressure (P = 0.38) and heart rate (P = 0.23) changes during spinal anesthesia and surgery failed to reveal any statistically significant differences between all groups through repeated measure analysis. CONCLUSION: The use of combined lower dose of misoprostol-oxytocin significantly reduced the amount of blood loss during and after the lower segment cesarean section compared to higher dose of oxytocin and misoprostol alone, and its use was not associated with any serious side effects.
Authors: Richard J Derman; Bhalchandra S Kodkany; Shivaprasad S Goudar; Stacie E Geller; Vijaya A Naik; M B Bellad; Shobhana S Patted; Ashlesha Patel; Stanley A Edlavitch; Tyler Hartwell; Hrishikesh Chakraborty; Nancy Moss Journal: Lancet Date: 2006-10-07 Impact factor: 79.321
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