Comparison between the Use of Misoprostol Plus Oxytocin versus Oxytocin Alone to Reduce the Intraoperative and Postoperative Hemorrhage during Cesarean Section
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- Category: Vol. 85, June 2017
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Comparison between the Use of Misoprostol Plus Oxytocin versus Oxytocin Alone to Reduce the Intraoperative and Postoperative Hemorrhage during Cesarean Section, MOFEED F. MOHAMED, EMAD M. ABD EL-ATIF and KARIM M. ABD EL-KARIM
Abstract
Objective: This study was designed to compared the efficacy of administration of oxytocin plus misoprostol versus oxytocin alone during cesarean section to reduce intra-operative and post-operative bleeding in cesarean section.
Study Design: This was an interventional prospective controlled study assessing the use of postpartum rectal miso-prostol in addition to intraoperative IV infusion of oxytocin during cesarean delivery to reduce intra-operative and post-operative blood loss in comparison with routinely used intra operative fi IV infusion oxytocin injection alone. The study was composed of 80 women undergoing cesarean delivery under general or spinal anaesthesia, subjects included in the study randomized into two groups:
•The first group (40 women): Received post-partum miso-prostol 800mcg, administered rectally in addition to intra-operative 10IU of IV infusion of oxytocin.
•The second group (40 women): Received intra-operative 10 IU infusion of oxytocin after the delivery of the neonate as slow IV dose.
Results: In our study, differences in the age, parity and gestational age were statistically insignificant among the two groups. In our study, 22.5% among the first group patients needed further uterotonic agents compared to 32.5% of the patients in the other group, also 15% out of the first group needed blood transfusion, compared to 17.5% of the second group, which is statistically insignificant. According to our study, no statistical significance was found between IV oxy-tocin alone and post-operative rectal misoprostol in addition to intra-operative IV oxytocin in the estimated mean operative blood loss, hemoglobin and hematocrit values preoperatively and postoperatively and pulse and mean arterial pressure measured both pre-operatively and post-operatively.
Conclusion: In comparison between oxytocin plus miso-prostol and oxytocin alone in the management of the third stage of labour. Oxytocin was preferred in our study and misoprostol an option when oxytocin not available.