Effect of Preoperative use of Misoprostol on Mean Change in Hemoglobin in Patients Undergoing Caesarean Section
DOI:
https://doi.org/10.37018/EDSW9632Keywords:
Caesarean Section, Obstetric blood loss, pre-operative misoprostol, HemoglobinAbstract
Background: Blood loss during caesarean section is a common complication and adversely affects the perinatal outcome. Measures to reduce blood loss and subsequent need for transfusion have always gained attraction in clinical practice. Misoprostol, known for its role in managing obstetric bleeding, is reported to be more effective when administered preoperatively. This study was conducted to evaluate the effect of preoperative per rectal misoprostol on mean change in hemoglobin concentration in patients undergoing caesarean section.
Methods: A Randomized controlled trial was conducted at the Department of Obstetrics and Gynecology, Sir Ganga Ram Hospital, Lahore from 3rd October 2020 to 2nd April 2021. Women undergoing caesarean section (CS) were either given 800µg per-rectal misoprostol preoperatively or no misoprostol at all in addition to IV Oxytocin infusion in all patients. Preoperative and postoperative hemoglobin and hematocrit levels along with their difference levels were measured and data was analyzed using SPSS version 20.0.
Results: A total of 62 patients were randomized into two groups of 31 patients each. Group A and B had similar mean ages (27.55 ± 3.92 vs. 26.00 ± 3.93 years) and gestational ages (38.97 ± 1.05 vs. 39.16 ± 1.04 weeks). The most common indication of CS was failed induction (45.2%) followed by breech presentation (30.6%). The mean change in hemoglobin was significantly lower in misoprostol group as compared to the group which did not receive misoprostol at all (0.65 ± 0.30 vs. 1.13 ± 0.37 g/dL; p < 0.05). The mean change of hematocrit was significantly lower in misoprostol group as compared to group which did not receive misoprostol at all (1.56 ± 0.96% vs. 1.56 ± 0.85%; p = 0.978)
Conclusion: Pre-operative per-rectal misoprostol resulted in significantly lesser change in hemoglobin, which suggests optimal control of blood loss during surgery with pre-operative misoprostol. Therefore, preoperative use of per-rectal misoprostol may be recommended in future practice as prophylactic uterotonic in clinical practice for reducing PPH and transfusion related complications.
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Copyright (c) 2026 Saba Anwar Bajwa, Hassan Anwar Bajwa, Noreen Akmal
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