The Effect of Combined Oxytocin–Misoprostol Versus Oxytocinudand Misoprostol Alone in Reducing Blood Loss at CesareanudDelivery: A Prospective Randomized Double-Blind Study

摘要

AbstractudPurpose To compare the effect of combined oxytocin–udmisoprostol versus oxytocin and misoprostol alone inudreducing blood loss at cesarean delivery.udMethods One hundred fifty patients of 18–40 years withudsingleton term pregnancies scheduled for cesarean sectionudunder spinal anesthesia were recruited in a prospectiveuddouble-blind randomized clinical trial to one of the threeudfollowing groups to receive 20 IU infusion of oxytocinud(group O), 400-lg sublingual misoprostol tablets (groupudM) or 200-lg misoprostol plus 5 IU bolus intravenousudoxytocin (group MO) after delivery. The hemoglobin leveludbefore surgery and 24 h after surgery, the need for additionaludoxytocic therapy, and the incidence of adverseudeffects were recorded.udResults The mean blood loss during surgery was significantlyudlower in group MO compared to other groupsud(P = 0.04). Comparison of mean arterial pressureud(P = 0.38) and heart rate (P = 0.23) changes during spinaludanesthesia and surgery failed to reveal any statisticallyudsignificant differences between all groups through repeatedudmeasure analysis.udConclusion The use of combined lower dose of misoprostol–udoxytocin significantly reduced the amount of bloodudloss during and after the lower segment cesarean sectionudcompared to higher dose of oxytocin and misoprostol alone,udand its use was not associated with any serious side effects.