Comparison of Rectal Misoprostol’s Effect When Used Before And After An Elective Cesarean Section On Post Cesarean Bleeding

Authors

  • roqea khansa Tishreen University
  • Lina Ramadan Tishreen University
  • Louai Hassan Tishreen University

Abstract

 

Introduction: Cesarean deliveries are among the most common major surgical interventions among women. Nevertheless, cesarean deliveries can lead to serious fetal or maternal complications, including primary postpartum hemorrhage (PPH), which can be a fatal complication and is the most common cause of maternal mortality worldwide, leading to over

100 000 maternal deaths annually.

Misoprostol, a synthetic prostaglandin E1 analog, is widely used in obstetrics for the prevention and control of blood loss. Previous reports have shown that misoprostol is effective in reducing blood loss during and after cesarean delivery, whether administered orally, intravenously, or rectally. However, the optimum time for administration of misoprostol to achieve maximum blood loss reduction has not been adequately addressed. Therefore, the aim of the present study was to compare the efficacy of preoperative and postoperative rectally administered misoprostol (400 µg) in blood loss reduction during elective cesarean delivery to determine the optimum time for drug administration.

 

Materials and methods: A number of 180 women who were admitted to our hospital because of elective cesarean section entered this clinical trial. They were divided into two groups. Group 1 received 400-μg of rectal misoprostol before the cesarean section and group 2 received 400-μg of rectal misoprostol after the surgery, the primary outcome was blood loss after cesarean delivery, Secondary outcomes were use of additional uterotonic drugs, postoperative hemoglobin and hematocrit concentration, change in hemoglobin and hematocrit concentration, adverse effects, and fetal and maternal morbidity.

 

Results: The mean estimated blood loss after cesarean delivery was significantly lower in group 1 than in group 2. Similarly, more patients in group 2 than in group 1 needed additional uterotonic drugs. The estimated postoperative hemoglobin and hematocrit levels were significantly lower in group 2 than in group 1 as was the change in hemoglobin and hematocrit levels.

 

Conclusion: 400 μg rectally administered misoprostol given before surgery more effectively reduced blood loss during elective cesarean than did postoperative administration. Furthermore, the frequency of adverse events did not vary depending on the timing of misoprostol administration.

Keywords: Cesarean delivery, rectal misoprostol, postpartum hemorrhage

Downloads

Published

2023-07-18

How to Cite

1.
خنسة ر, لينا رمضان, لؤي حسن. Comparison of Rectal Misoprostol’s Effect When Used Before And After An Elective Cesarean Section On Post Cesarean Bleeding. Tuj-hlth [Internet]. 2023Jul.18 [cited 2024Apr.28];45(3):295-308. Available from: https://journal.tishreen.edu.sy/index.php/hlthscnc/article/view/14855

Issue

Vol. 45 No. 3 (2023): Tishreen University Journal for Research and Scientific Studies - Health Sciences Series

Section

Master student researches

License

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

The authors retain the copyright and grant the right to publish in the magazine for the first time with the transfer of the commercial right to Tishreen University Journal for Research and Scientific Studies - Health Sciences Series

 Under a CC BY- NC-SA 04 license that allows others to share the work with of the work's authorship and initial publication in this journal. Authors can use a copy of their articles in their scientific activity, and on their scientific websites, provided that the place of publication is indicted in  Tishreen University Journal for Research and Scientific Studies - Health Sciences Series   .  The Readers have the right to send, print and subscribe to the initial version of the article, and the title of  Tishreen University Journal for Research and Scientific Studies - Health Sciences Series  Publisher

journal uses a CC BY-NC-SA license which mean

You are free to:

  • Adapt — remix, transform, and build upon the material
  •  
  • The licensor cannot revoke these freedoms as long as you follow the license terms.

 

  • Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
  • NonCommercial — You may not use the material for commercial purposes.
  • ShareAlike — If you remix, transform, or build upon the material, you must distribute your contributions under the same license as the original.
  • No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.