Uterotonic effect of rectal misoprostol as preoperative medication for assessment of intraoperative and postoperative blood loss in cesarean delivery

Urmila Karya, Shweta Maheshwari, Anupam Rani


Background: Postpartum hemorrhage is the leading cause of maternal mortality and it's prevention has been identified as key component of safe motherhood. Misoprostol is an effective uterotonic for prophylaxis and control of PPH. Aim of our study was to evaluate the effect of preoperative rectal misoprostol (400μg) on blood loss during and after cesarean delivery.

Methods: It was a randomised controlled trial done on 200 women scheduled for elective cesarean delivery. Eligible participants were randomized into two groups. In the study group 100 women received a preoperative 400 μg per rectal misoprostol tablet just after spinal anaesthesia while 100 women assigned to the control group did not receive misoprostol tablet.

Results: The mean intra operative and postoperative blood loss was lower in study group than the control group 345.98±79.57 ml and 114±19.97 ml versus 408.6±63.68 ml and 136.38±24.81 ml, respectively. The difference between the preoperative and postoperative hematocrit values was also significantly lower in the study group than the control group (33.43±1.93 and 33.64±1.82)

Conclusions: In our study it was concluded that preoperative 400 μg rectal misoprostol is effective in reducing intraoperative and postoperative blood loss, thus preventing postpartum hemorrhage and reducing incidence of overall maternal morbidity and mortality.


Misoprostol, Preoperative medication, Caesarean delivery, Postpartum hemorrhage

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