A comparison of rectal misoprostol and intravenous oxytocin on hemorrhage and homeostatic changes during cesarean section

Abstract

Background: Post partum bleeding is a major cause of mortality and morbidity in pregnant women. In this study the effects of rectal misoprostol and oxytocin on post-cesarean bleeding are compared.

Methods: In this clinical trial 100 pregnant women candidate of elective cesarean section (CS) were randomly allocated in one of two groups of patients receiving either 400 micro g of misoprostol, rectally, after spinal anesthesia, or intravenous oxytocin, after delivery of the baby. Intra-operative bleeding, hemoglobin level before and 24 hour after operation, mean arterial blood pressure, heart rate before and after the administration of the drugs, and adverse drug effects.

Results: There was no difference between the groups in age, duration and number of pregnancy, and surgery. The amount of the blood lost in misoprostol group was 578+/-185 cc, and in oxytocin group 620+/-213 cc (p=0.39). Decrease in hemoglobin level in the two groups was not statistically significant (p=0.55). Changes in mean arterial pressure and heart rate were only significant in oxytocin group. Shivering was significantly more common in the misoprostol group and respiratory distress in the oxytocin group. Other adverse effects were equally seen in both groups.

Conclusion: Misoprostol is an appropriate alternative for intravenous oxytocin in patients undergoing cesarean section, with lesser side effects and longer duration of action.