Study on use of Sublingual Misoprostol to Reduce Blood Loss at Caesarean Delivery in Tertiary Care Centre

Objective: This prospective randomized controlled study was carried out with the purpose of assessing the efficacy of sublingual misoprostol in decreasing intraoperative blood loss and the need for additional uterotonic agents at cesarean delivery. Methods: One hundred 110 women undergoing elective or emergency cesarean delivery were assigned randomly to receive either 600 μg misoprostol or placebo sublingually at the time of cord clamping. Simultaneoulsy oxytocin 20 units (10 units in IV drip and 10 Intramuscular) was given. The primary outcome measures were intraoperative blood loss, need for additional uterotonic agents, and perioperative hemoglobin (Hb) fall. Results: The maternal demographic factors, indications for cesarean delivery were similar between the two groups. Mean intraoperative blood loss was significantly less in misoprostol group as compared with placebo group (510 ± 100 vs. 670 ± 110 ml). Fewer women needed additional uterotonic agents in misoprostol group (20.2 vs. 40.5 %). Perioperative Hb fall was significantly less in misoprostol group (0.77 ± 0.25 vs. 1.05 ± 0.25 g). Conclusion: Sublingual misoprostol decreases intraoper-ative blood loss and the need for additional uterotonic agents at cesarean delivery.

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