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Randomized Controlled Trial
. 2023 Nov;51(11):3000605231213242.
doi: 10.1177/03000605231213242.

Preoperative versus postoperative misoprostol use for prevention of blood loss during caesarean section in pregnant women at term: a multi-centre randomised controlled trial

Leonard Ogbonna Ajah  1   2 , Monique Iheoma Ajah  1 , Hyginus Uzo Ezegwui  1   2 , Theophilus Ogochukwu Nwankwo  1   2 , Chukwuemeka Anthony Iyoke  1   2 , Wilson Ndukwe Nwigboji  3
Affiliations
Randomized Controlled Trial

Preoperative versus postoperative misoprostol use for prevention of blood loss during caesarean section in pregnant women at term: a multi-centre randomised controlled trial

Leonard Ogbonna Ajah et al. J Int Med Res. 2023 Nov.

Abstract

Objective: Caesarean section is associated with higher blood loss than vaginal delivery. This study was performed to compare the safety and efficacy of preoperative versus postoperative rectal and sublingual misoprostol use for prevention of blood loss in women undergoing elective caesarean delivery.

Methods: Eligible patients in Southeast Nigeria were randomly classified into those that received 600 µg of preoperative rectal, postoperative rectal, preoperative sublingual, and postoperative sublingual misoprostol. All patients received 10 units of intravenous oxytocin immediately after delivery. Data were analysed with SPSS Version 23.

Results: Preoperative sublingual misoprostol use caused the highest postoperative packed cell volume, least change in the packed cell volume, and lowest intraoperative blood loss. Preoperative sublingual and rectal misoprostol use was associated with better haematological indices and maternal outcomes than postoperative use by these routes. However, preoperative sublingual and rectal use caused more maternal side effects than postoperative use by these routes.

Conclusion: Preoperative sublingual misoprostol was associated with the most favourable haematological indices. Although preoperative sublingual and rectal misoprostol use caused more maternal side effects, these routes were associated with better haematological indices and maternal outcomes than postoperative sublingual and rectal misoprostol use.

Keywords: Caesarean section; Nigeria; blood loss; postoperative; preoperative; rectal misoprostol; sublingual misoprostol.

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Conflict of interest statement

Declaration of conflicting interestsThe authors have no conflicts of interest.

Figures

Figure 1.
Figure 1.
Flow chart of patient selection.
See this image and copyright information in PMC

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