Prophylactic effect of rectal and sublingual misoprostol on postpartum hemorrhage in mothers with preeclampsia following cesarean section surgery; a double-blind randomized controlled trial

Afkham, Mansoureh Sadeghi; Hashemnejad, Maryam; Saeieh, Sara Esmaelzadeh; Ataei, Mina; Valizadeh, Rohollah

doi:10.1016/j.amsu.2022.104175

Cited by 1 publication

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“…In this study, the impact of misoprostol and tranexamic acid administered preoperatively significantly reduced intraoperative blood loss. This is in keeping with previous reports, which showed the effects of the preoperative administration of these agents on blood loss during caesarean delivery [ 15 - 20 ]. In comparing the mean blood loss in our study with one of the ‘misoprostol only’ studies, we found that the mean blood loss in these women who received a combination of misoprostol and TXA was 308.55±42.99 mL compared to the mean of 595±108 mL in women treated with misoprostol alone [ 21 ].…”

Section: Discussionsupporting

confidence: 93%

Effectiveness of Combined Preoperative Sublingual Misoprostol and Intravenous Tranexamic Acid on Intraoperative Blood Loss During Elective Caesarean Section: A Randomised, Blinded, Placebo-Controlled Trial

Akpan,

Ugwuoke,

Ekpo

et al. 2023

Cureus

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Introduction: The objective of this study was to evaluate the effect of preoperative administration of sublingual misoprostol and intravenous tranexamic acid (TXA) on intraoperative blood loss during elective caesarean sections. Methods: This was a double-blinded, randomised, placebo-controlled study involving 116 women scheduled for elective caesarean sections. The treatment arm, group 1 (n=58), received 1000 mg of intravenous tranexamic acid 10-15 minutes before skin incision and 600 mcg of sublingual misoprostol after sub-arachnoid anaesthesia and before skin incision. Group 2 (n=58) received placebos; both groups had oxytocin injections at the delivery of the placenta. The data were analyzed using IBM® Statistical Package for the Social Sciences (SPSS) version 24 (IBM Corp., Armonk, NY). Results: The primary outcome was the intraoperative blood loss and the difference between preoperative and postoperative hematocrit values in both groups. The mean intraoperative blood loss was significantly lower in the study group than in the control group (308.552 ± 42.991 mL versus 736.414 ± 171.889 mL, p<0.001). The differences between the preoperative and post-operative hematocrit values were also significantly lower in the study group than in the control group (2.212% ± 0.805% versus 5.660% ± 2.496%, p<0.001). Conclusion: Preoperative administration of 1000 mg of intravenous tranexamic acid and 600 mcg of sublingual misoprostol significantly reduced blood loss related to elective caesarean delivery.

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Section: Discussionsupporting

confidence: 93%