Oral misoprostol vs. intravenous oxytocin in reducing blood loss after emergency cesarean delivery.

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%.

• Authors: O Lapaire, M C Schneider, M Stotz, D V Surbek, W Holzgreve, I M Hoesli
• Journal: International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics (Int J Gynaecol Obstet) Vol. 95 Issue 1 Pg. 2-7 (Oct 2006) ISSN: 0020-7292 [Print] United States
• PMID: 16934269 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Oxytocics
• Misoprostol
• Oxytocin

Topics

• Administration, Oral
• Adult
• Cesarean Section (methods)
• Double-Blind Method
• Female
• Hemostasis, Surgical (methods)
• Humans
• Injections, Intravenous
• Misoprostol (therapeutic use)
• Oxytocics (therapeutic use)
• Oxytocin (therapeutic use)
• Pilot Projects
• Postpartum Hemorrhage (drug therapy)
• Pregnancy
• Prospective Studies
• Treatment Outcome