Randomized Controlled Trial of Sublingual and Rectal Misoprostol Administration on Blood Loss at Elective Caesarean Section (Published)
Background: Misoprostol is widely used in the prophylaxis and treatment of Postpartum Hemorrhage (PPH). However, there is paucity of information on its effect on the volume of blood loss with regard to the route of administration in patients undergoing elective caesarean section. Aim: This study compares the effect of sublingual versus rectal administrations of misoprostol on blood loss in subjects undergoing elective caesarean section. Methodology: An open-label controlled trial was conducted on 72 women undergoing elective caesarean section randomized either to receive 600 mg misoprostol rectally (36 subjects) or sublingually (36 subjects). Blood loss, Hemoglobin (Hb) concentration and Packed Cell Volume (PCV) where measured using Standard Techniques. These in addition to side effects of misoprostol were compared in both groups. Results were expressed as Mean ± S.D were analyzed using Student’s t-test and Chi-square and p < 0.05 was considered statistically significant. RESULTS: Mean intraoperative blood loss was significantly less in the sublingual group compared to the rectal group (602.87±131.96 vs 705.83 ± 142.24 ml, p = 0.002. Mean postoperative Hb (g) was higher in the sublingual group 10.00 ± 1.13g/dl vs 9.63 ±0.76 g/dl, p = 0.463. Perioperative Hb fall was less in the sublingual group (1.17 ± 1.08 g/dl vs 1.49 ± 0.99 g/dl, p = 0.193.CONCLUSION: Study suggests that sublingual administration of misoprostol is more effective in reducing intraoperative blood loss at elective Caesarean than rectal administration.
Keywords: Misoprostol, PPH, Rectal, Sublingual, caesarean section