The effect of post‐cesarean rectal misoprostol on intestinal motility

Adanikin, Abiodun Idowu; Orji, Ernest O.; Fasubaa, OB; Onwudiegwu, U.; Ijarotimi, Omotade Adebimpe; Olaniyan, O.

doi:10.1016/j.ijgo.2012.05.033

Cited by 9 publications

(10 citation statements)

References 18 publications

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“…17,22,23,63 Some trials have reported that misoprostol has the additional effect of increasing intestinal motility after cesarean delivery and allowing early oral feeding, which could reduce the risk of postoperative ileus and shortened hospital stay length, and allow early breastfeeding. 64-66 This effect has been reported in trials that administered misoprostol rectally after surgery, but it is unclear if similar effects can be obtained if the drug is administered sublingually.…”

Section: Commentmentioning

confidence: 83%

Misoprostol to reduce intraoperative and postoperative hemorrhage during cesarean delivery: a systematic review and metaanalysis

Conde-Agudelo

Díaz

Rosas-Bermúdez

et al. 2013

American Journal of Obstetrics and Gynecology

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OBJECTIVE To evaluate the efficacy and safety of prophylactic misoprostol use at cesarean delivery for reducing intraoperative and postoperative hemorrhage. STUDY DESIGN Systematic review and meta-analysis of randomized controlled trials. RESULTS Seventeen studies (3174 women) were included of which 7 evaluated misoprostol versus oxytocin and 8 evaluated misoprostol plus oxytocin versus oxytocin. Overall, there were no significant differences in intraoperative and postoperative hemorrhage between sublingual or oral misoprostol and oxytocin. Rectal misoprostol, compared with oxytocin, was associated with a significant reduction in intraoperative and postoperative hemorrhage. The combined use of sublingual misoprostol and oxytocin, compared with the use of oxytocin alone, was associated with a significant reduction in the mean decrease in hematocrit (mean difference, −2.1%; 95% confidence interval [CI], −3.4 to −0.8) and use of additional uterotonic agents (relative risk, 0.33; 95% CI, 0.18-0.62). Compared with oxytocin alone, buccal misoprostol plus oxytocin reduced the use of additional uterotonic agents; rectal misoprostol plus oxytocin decreased intraoperative and postoperative blood loss, mean fall in hematocrit, and use of additional uterotonic agents; and intrauterine misoprostol plus oxytocin reduced the mean fall in hemoglobin and hematocrit. Women receiving misoprostol, alone or combined with oxytocin, had a higher risk of shivering and pyrexia. CONCLUSION Misoprostol combined with oxytocin appears to be more effective than oxytocin alone in reducing intraoperative and postoperative hemorrhage during caesarean section. There were no significant differences in intraoperative and postoperative hemorrhage when misoprostol was compared to oxytocin. However, these findings were based on a few trials with methodological limitations.

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Section: Commentmentioning

confidence: 83%

Misoprostol to reduce intraoperative and postoperative hemorrhage during cesarean delivery: a systematic review and metaanalysis

Conde-Agudelo

Díaz

Rosas-Bermúdez

et al. 2013

American Journal of Obstetrics and Gynecology

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“…The aetiology and pathogenesis of POI is multifactorial; therefore, a multimodal approach is required to counteract the morbidity of POI. These measures include preoperative optimisation; gentle bowel handling; early feeding; avoidance of nonessential use of nasogastric tubes; thoracic epidural analgesia; use of pharmacological agents such as water‐soluble contrast agents, alvimopan (a selective μ ‐receptor opioid antagonist), misoprostol and ketorolac; and gum chewing …”

Section: Introductionmentioning

confidence: 99%

Chewing gum in preventing postoperative ileus in women undergoing caesarean section: a systematic review and meta‐analysis of randomised controlled trials

Craciunas

Sajid

Ahmed

2014

BJOG

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Background The incidence of postoperative ileus (POI) after gynaecological surgery is 10-15% Chewing gum following general surgery improves outcomes, including early flatus, early bowel sounds, and shortening of hospitalisation periods. There is currently no guideline that supports the use of chewing gum after caesarean sections.Objectives To systematically analyse the published randomised controlled trials regarding the effectiveness of chewing gum in preventing POI in women undergoing caesarean sections.Search strategy Systematic search of medical databases up to March 2013.Selection criteria Randomised controlled trials that reported the role of chewing gum in preventing POI in women undergoing caesarean sections.Data collection and analysis Two authors independently identified the relevant studies for inclusion, extracted outcome-related data, and analysed it systematically using REVMAN â . The combined outcome was expressed as an odds ratio and standardised mean difference.Main results Seven randomised controlled trials involving 1462 women (728 in the chewing gum group, 734 controls) were systematically analysed. There was significant heterogeneity (v 2 = 29.02, df = 7; P < 0.0001; I 2 = 76%) among the included trials. Among women undergoing caesarean sections, chewing gum reduced the risk of POI (odds ratio 0.36; 95% confidence interval 0.19-0.69; z = 3.08; P < 0.002) but did not affect duration of hospitalisation (P = 0.32).Conclusions Chewing gum for 30-60 minutes at least three times a day appears to be effective in reducing the incidence and consequences of POI following caesarean sections.

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“…Intraoperative blood loss was routinely calculated in all the patients using the formula: (A + B) -C 20 , in which A refers to the difference between pre-and post-surgery weights of surgical towels in grams were determined with the precision digital scales, B refers to the volume of the contents of the "suction" bottle (ml), and C refers to the amniotic fluid volume (AFV) (ml).The uterus was divided into four quadrants, by the linea nigra, to the right and left quadrants, and the umbilicus to the lower and upper quadrants. The deepest vertical diameter of the amniotic fluid was measured in centimeters per quadrant 21 .…”

Section: Methodsmentioning

confidence: 99%

“…When the literature is reviewed, although there are many publications with the use of rectal misoprostol and postpartum bleeding, only two studies on intestinal motility have been identified. The role of rectal misoprostol administration on intestinal motility was effective in one of these studies and ineffective in the other 17,20 . To contribute to the uncertainty in this matter this study was designed to determine the effectiveness of rectal administered misoprostol in inducing the early motility of the gastrointestinal tract and reducing the amount of postpartum uterine bleeding in primiparous women.…”

Section: Introductionmentioning

confidence: 97%

Sezaryen sonrası rektal olarak uygulanan misoprostolün bağırsak motilitesi ve uterus kanaması üzerine etkileri

Gül

2020

Cukurova Medical Journal

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Öz Purpose: This study was designed to determine the effectiveness of rectal misoprostol administered in primiparous women after elective cesarean to the motility of the gastrointestinal tract and postpartum hemorrhage. Materials and Methods: This study was conducted as a retrospective cohort study of 240 patients who were administrated rectal misoprostol (misoprostol group, n=120) or intravenous oxytocin (non-misoprostol group n=120) during the postpartum period in a single institution between April 2018 and March 2019 Results: The median values of the first flatulation and defecation time were statistically significantly earlier in the misoprostol group than in the non-misoprostol group (the first flatulation time was 18 hours and 24 hours respectively, the first defecation time was 29 hours and 36 hours respectively). The comparison of the two groups in terms of postoperative hemoglobin and hematocrit values demonstrated that hemoglobin and hematocrit values measured at the postoperative 24 th hour (the hemoglobin was 11 g/dL and 10,2 g/dL respectively, the hematocrit was 33% and 30.6% respectively) were statistically significantly higher in the misoprostol group than were those in the non-misoprostol group. Postoperative fever and shivering, negative effects of misoprostol, were more frequent in the misoprostol group than in the nonmisoprostol group. Conclusions: In the present study, demonstrated that the administration of rectal misoprostol after CS led to the early flatulation and defecation by increasing the motility of the gastrointestinal tract and reduced the amount of postpartum hemorrhage in the women.

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The effect of post‐cesarean rectal misoprostol on intestinal motility

Abstract: After cesarean delivery, rectal misoprostol had the added benefit of inducing intestinal motility. Misoprostol might be considered in a clinical setting where postoperative ileus is anticipated.

Cited by 9 publications

References 18 publications

Misoprostol to reduce intraoperative and postoperative hemorrhage during cesarean delivery: a systematic review and metaanalysis

Misoprostol to reduce intraoperative and postoperative hemorrhage during cesarean delivery: a systematic review and metaanalysis

Chewing gum in preventing postoperative ileus in women undergoing caesarean section: a systematic review and meta‐analysis of randomised controlled trials

Sezaryen sonrası rektal olarak uygulanan misoprostolün bağırsak motilitesi ve uterus kanaması üzerine etkileri

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