Oral Misoprostol Vs. Intravenous Oxytocin in Reducing Blood Loss After Emergency Cesarean Delivery

Overview

Journal Int J Gynaecol Obstet

Publisher Wiley

Specialty Gynecology & Obstetrics

Date 2006 Aug 29

PMID 16934269

Citations 13

Authors

O Lapaire

M C Schneider

M Stotz

D V Surbek

W Holzgreve

I M Hoesli

Affiliations

Soon will be listed here.

Abstract

Objective: To compare the effectiveness of oral misoprostol and intravenous oxytocin in reducing blood loss in women undergoing indicated or elective cesarean delivery (CD) under spinal anesthesia.

Methods: In this prospective, double-blind pilot study, 56 parturients who received 5 IU of intravenous oxytocin after cord clamping were randomized to further receive either misoprostol orally and a placebo infusion intravenously or placebo orally and an oxytocin infusion intravenously.

Results: After adjustment was made for the sonographically estimated amniotic fluid volume, there was no statistical difference in blood loss between the 2 groups (mean+/-S.D., 1083+/-920 mL in the oxytocin group vs. 970+/-560 mL in the misoprostol group; P=.59).

Conclusion: Oxytocin followed by oral misoprostol is as effective as an oxytocin injection followed by an oxytocin infusion in reducing postoperative blood loss after CD, and the protocol may be a safe, valuable, and cost-effective alternative to oxytocin alone. Visual estimation of intraoperative blood loss undervalues the effective value of misoprostol use by 30%.

Citing Articles

Uterotonic agents for preventing postpartum haemorrhage: a network meta-analysis.

Gallos I, Papadopoulou A, Man R, Athanasopoulos N, Tobias A, Price M Cochrane Database Syst Rev. 2018; 12:CD011689.

PMID: 30569545 PMC: 6388086. DOI: 10.1002/14651858.CD011689.pub3.

Peripartum Haemorrhage, Diagnosis and Therapy. Guideline of the DGGG, OEGGG and SGGG (S2k Level, AWMF Registry No. 015/063, March 2016).

Schlembach D, Helmer H, Henrich W, von Heymann C, Kainer F, Korte W Geburtshilfe Frauenheilkd. 2018; 78(4):382-399.

PMID: 29720744 PMC: 5925693. DOI: 10.1055/a-0582-0122.

Uterotonic agents for preventing postpartum haemorrhage: a network meta-analysis.

Gallos I, Williams H, Price M, Merriel A, Gee H, Lissauer D Cochrane Database Syst Rev. 2018; 4:CD011689.

PMID: 29693726 PMC: 6494487. DOI: 10.1002/14651858.CD011689.pub2.

Lack of controlled studies investigating the risk of postpartum haemorrhage in cesarean delivery after prior use of oxytocin: a scoping review.

Bischoff K, Nothacker M, Lehane C, Lang B, Meerpohl J, Schmucker C BMC Pregnancy Childbirth. 2017; 17(1):399.

PMID: 29187156 PMC: 5708177. DOI: 10.1186/s12884-017-1584-1.

The Effect of Combined Oxytocin-Misoprostol Versus Oxytocin and Misoprostol Alone in Reducing Blood Loss at Cesarean Delivery: A Prospective Randomized Double-Blind Study.

Pakniat H, Khezri M J Obstet Gynaecol India. 2015; 65(6):376-81.

PMID: 26663995 PMC: 4666219. DOI: 10.1007/s13224-014-0607-3.