Effect of Sublingual Misoprostol on Blood Loss during and after Cesarean Section
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- Category: Vol. 85, September 2017
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Effect of Sublingual Misoprostol on Blood Loss during and after Cesarean Section, YEHIA A. WAFA, FAHAD A. EL-OMDA, MOHAMED E. HAMMOUR and SAEID M. EL-KELEENY
Abstract
Background: Cesarean section is the most common major operation performed on women worldwide. Despite routine use of oxytocin during cesarean delivery, a number of women especially those at high risk may develop uterine atony and hemorrhage either during surgery or in the immediate postop-erative period, with serious consequences. Any modality of treatment which helps in its prevention will be useful in reducing maternal mortality and morbidity. Misoprostol is an evidence-based alternative to other uterotonic agents which require a cold chain, skilled administration, and have untoward effects in therapeutically effective doses. Further, the drug’s wide availability, low-cost, stability at room temperature, and ease of use make it an ideal drug for use in such settings.
Aim of Work: The aim of the study was study the effect of sublingual misoprostol on blood loss during and after cesarean section.
Patients and Methods: This study was carried out on 200 cases pregnant women, fulfilling the inclusion criteria, attend-ing to El-Hussein university Hospital, during the study period from October 2016 – April 2017, who are planned for delivery. The 200 cases was randomized into 2 Groups: Group 1: One hundred women received 400 mcg misoprostol. Group 2: One hundred women received placebo, Both misoprostol and placebo were sublingually at the time of cord clamping. Intraoperative and postpartum blood loss were calculated by the numbers of soaked towels before irrigation.
Results: There was no statistical significant difference between the two studied groups regarding haematocrit level at different times (preoperative, and postoperative.Amount of actual blood loss in group A ranged from 321.59-1063.9 with mean value 648. 15-}190.54 and in group B ranged from 172.27-1227.74 with mean value 753.83-}264.86. There was statistical significant increase in blood loss in group B more than group A. Amount of estimated blood loss in group A ranged 299-960 with mean value 628.28-}159.34 and in group B ranged from 190-1190 with mean value 725.50-}227.35. There was statistical significant difference between the two studied groups regarding amount of estimated blood loss, the blood loss in group B was higher than group A comparison between the two studied groups regarding the post operative complication, it was found that the post partum hemorrhage was significantly higher in group B more than group A, while the shivering was significantly higher in group A more than group B, the pyrexia, nausea and vomiting was matched in the two studied groups without significant difference (p>0.05). Hospital stay in group A ranged from 1-4 with mean value 2.04-}0.88 and in group B ranged from 1-5 with mean value 1.93-}0.78. There was no statistical significant difference between the two studied groups regarding duration of hospital stay.
Conclusion: Sublingual misoprostol reduces operative and postoperative blood loss and the need for additional uterotonic agents at cesarean section.