PRE-OPERA PRE-OPERATIVE USE OF MISOPROSTOL IN MAJOR TIVE USE OF MISOPROSTOL IN MAJOR TIVE USE OF MISOPROSTOL IN MAJOR TIVE USE OF MISOPROSTOL IN MAJOR TIVE USE OF MISOPROSTOL IN MAJOR GYNAECOLOGICAL SURGERIES OGICAL SURGERIES

ABSTRACT ABSTRACT ABSTRACT ABSTRACT Objective: To study the effect of preoperative use of misoprostol on reducing blood loss in Major gynaecological surgeries. Material and Methods: This was a hospital based interventional study conducted in the department of Obstetrics and Gynaecology, Khyber Teaching Hospital, Peshawar, Pakistan from March 2010 to November 2012. A total of 100 cases were studied in this comparative trial. Randomly selected 50 patients had preoperative per rectal insertion of tablet misoprostol 400 micrograms 20 minutes prior to surgery and were compared to 50 other patients in whom no misoprostol was used before or during surgery. All of these were elective gynaecological surgeries including hysterectomies and myomectomies etc. Data was analyzed using SPSS. Results: A total of 100 cases were studied, in 50 patients, preoperative insertion of misoprostol 400 micrograms was carried out and 50 cases without its use were studied for comparison. Main outcome measures were approximate per-operative blood loss, need for transfusion and post op Hb (gm/dl). In the first group without misoprostol mean blood loss was 370ml + 170.233 SD and mean post-op Hb was 10.34 + 0.4102 SD. In the group with misprostol the mean blood loss was 310cc + 197.284 SD and mean postoperative Hb was 10.761 + 0.4998 SD. Six percetn of misoprostol group and 28% of no misoprostol needed transfusion. Conclusion: More studies are needed to establish the benefits of preoperative misoprostol before routine use of this drug is recommended.