The effect of intrauterine misoprostol on blood loss during caesarean section

Bahadur, Anupama; Khoiwal, Kavita; Bhattacharya, Namrata; Chaturvedi, Jaya; Kumari, Ranjeeta

doi:10.1080/01443615.2019.1581743

Cited by 9 publications

(9 citation statements)

References 12 publications

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“…Moreover, the number of patients who experienced excessive blood loss (>1000 mL) was significantly lower in the combined intrauterine misoprostol-oxytocin regimen (2 vs 10 cases when oxytocin was used alone). Similarly, Bahadur et al 22 The present study agrees with all the aforementioned studies on the extra benefit achieved by using intrauterine misoprostol to reduce blood loss during and after cesarean delivery and hence PPH.…”

Section: Discussionsupporting

confidence: 92%

“…Moreover, the number of patients who experienced excessive blood loss (>1000 mL) was significantly lower in the combined intrauterine misoprostol–oxytocin regimen (2 vs 10 cases when oxytocin was used alone). Similarly, Bahadur et al 22 concluded that the combined use of the intrauterine misoprostol and oxytocin infusion significantly reduces intraoperative and postoperative blood loss during cesarean delivery.…”

Section: Discussionmentioning

confidence: 96%

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A comparative study between preoperative rectal misoprostol and intraoperative intrauterine administration in the reduction of blood loss during and after cesarean delivery: A randomized controlled trial

Elsherbini

Maged

Helal

et al. 2020

Intl J Gynecology & Obste

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Objective To compare the efficacy and safety of rectal misoprostol with intrauterine misoprostol in the reduction of blood loss during and after cesarean delivery. Methods Ninety‐eight pregnant women, all candidates for elective cesarean delivery, were equally randomized into two groups: the rectal group (received preoperative misoprostol rectally) and the intrauterine group (received intrauterine misoprostol after the delivery of the placenta). The primary outcome was the estimated blood loss (EBL) during cesarean delivery. Secondary outcomes included the occurrence of excessive blood loss (>1000 mL) within the first 24 hours postoperatively and the occurrence of any maternal or fetal side effects. Results There were no statistically significant differences between the two groups regarding either the EBL (693.12 ± 139.09 vs 692.39 ± 132.83; P=0.979) or the occurrence of postpartum hemorrhage (>1000 mL) (6.1% vs 4.1%; P=0.99. Apgar scores at 1 and 5 minutes were significantly higher in the intrauterine group compared to the rectal group. Conclusion Insertion of intrauterine misoprostol is as effective as rectal insertion in reducing blood loss during and after cesarean delivery; however, it has a safer neonatal outcome and is more convenient when administered during cesarean delivery. ClinicalTrials.gov: NCT03723031.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 96%

A comparative study between preoperative rectal misoprostol and intraoperative intrauterine administration in the reduction of blood loss during and after cesarean delivery: A randomized controlled trial

Elsherbini

Maged

Helal

et al. 2020

Intl J Gynecology & Obste

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“…In this study, neither 400 μg, 600 μg nor 800 μg did not show any significant difference in the development of PPH. Each three different doses of misoprostol were supported by many prior literatures and all publication reported an effectiveness in reduction of PPH when combined with oxytocin [ 9 , 13 , 17 , 18 ]. Several comparison trails also summarized the positive impact of misoprostol 600 μg and 800 μg [ 9 , 16 ].…”

Section: Discussionmentioning

confidence: 72%

“…Misoprostol, in a tablet preparation, can be prescribed in different route including sublingual, oral, rectal and vaginal [ 16 ]. In addition, intrauterine insertion is well documented in many studies recently [ 9 , 17 , 18 ]. While an optimal dosage of intrauterine route has not been well established, range of dosage from 400 to 800 μg were used safely [ 16 , 19 ].…”

Section: Introductionmentioning

confidence: 99%

Optimal dose of misoprostol combined with oxytocin for preventing postpartum hemorrhage in cesarean section: A randomised controlled trial

Sringamwong¹,

Saokaew

Mongkhon

2022

Annals of Medicine &Amp; Surgery

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“…9 Bahadur et al evaluated intrauterine misoprostol with oxytocin and oxytocin alone on blood loss during caesarean section and concluded that intrauterine misoprostol leads to decrease in intra and post-operative blood loss with side effect of transient shivering. 10 Kumari et al evaluated impact of preoperative 200 mcg per rectal misoprostol on blood loss during and after caesarean delivery which resulted in significantly lower intra and post-operative blood loss in the misoprostol group as compared to placebo group. 11 Difference between pre and post-operative haematocrit values was also significantly lower in the study group compared to control group.…”

Section: Discussionmentioning

confidence: 99%

Sublingual misoprostol to reduce blood loss at caesarean delivery

Agarwal

Thakkar

2021

Int J Reprod Contracept Obstet Gynecol

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Background: Caesarean section is the most common obstetrical procedure performed worldwide. Sometimes oxytocin alone is not sufficient to prevent postpartum haemorrhage and additional uterotonics may be required. We attempted an additional uterotonic misoprostol by sublingual route to evaluate the role of it to reduce blood loss at caesarean delivery.Methods: This prospective clinical study was done on patients of S. S. G. Hospital, Baroda; 138 patients who underwent lower segment caesarean section (elective or emergency). The primary outcome was less intra/peri operative blood loss, need for additional uterotonic agents and perioperative haemoglobin (Hb) fall. The secondary outcomes studied were incidence of shivering, pyrexia, nausea, vomiting, operating time, blood transfusion, endomyometritis and hospitalization period. Average blood loss after normal vaginal delivery is 500 ml and after caesarean delivery is around 1000 ml.Results: Mean postoperative Hb was high with misoprostol group and perioperative Hb fall was less. Perioperative Hb fall of 1 g or more was lesser in this group.Conclusions: Sublingual misoprostol reduces intraoperative blood loss, perioperative blood loss and the need for additional uterotonic agents and blood transfusions at caesarean delivery.

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The effect of intrauterine misoprostol on blood loss during caesarean section

Cited by 9 publications

References 12 publications

A comparative study between preoperative rectal misoprostol and intraoperative intrauterine administration in the reduction of blood loss during and after cesarean delivery: A randomized controlled trial

A comparative study between preoperative rectal misoprostol and intraoperative intrauterine administration in the reduction of blood loss during and after cesarean delivery: A randomized controlled trial

Optimal dose of misoprostol combined with oxytocin for preventing postpartum hemorrhage in cesarean section: A randomised controlled trial

Sublingual misoprostol to reduce blood loss at caesarean delivery

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