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Corresponding Author

Lobna Gamal Mohamed El Said

Document Type

Original Article

Abstract

Background: Preventing postpartum hemorrhage (PPH) has been highlighted as an essential aspect of promoting safe motherhood. Misoprostol is a powerful uterotonic that can be used to prevent and manage preterm labor.

Aim and objectives: To assess the effect of sublingual and rectal misoprostol in reducing blood loss during and after cesarean delivery compared to oxytocin infusion.

Subjects and methods: The research was a prospective randomized controlled trial performed at AL-Zahraa University Hospital and Fayoum General Hospital's Obstetrics and Gynecology departments. The study was applied to 90 women subdivided into three groups (Group A), which included 30 participants received 400μg of misoprostol (two tablets) by sublingual route just before abdominal skin incision, (Group B): included 30 participants received 400μg of misoprostol rectally after induction of anesthesia and (Group C): included 30 participants received oxytocin 20 I.U. (syntocinon) intravenous infusion.

Results: There were highly statistically significant variances among the groups concerning intraoperative blood loss and total blood loss. Oxytocin had the upper hand over misoprostol in controlling blood loss, while rectal misoprostol (Mean ± S.D. 380.20±58.586) was superior to sublingual misoprostol (Mean ± S.D. 432.17±90.036) in reducing intraoperative blood loss with fewer adverse effects.

Conclusion: Oxytocin had the upper hand over misoprostol in controlling blood loss, while rectal misoprostol was superior to sublingual misoprostol. The usage of rectal misoprostol reduces intraoperative blood loss and has fewer adverse effects than sublingual misoprostol.

Keywords

Cesarean delivery; Misoprostol; Postpartum hemorrhage; Rectal; Sublingual

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