Main Article Content
C-Section, Blood Loss, Misoprostol, Oxytocin
Background: The rise in maternal mortality has been linked to a nationwide increase in C-section rates, however, this surge has outpaced the rise in the caesarean section rate, which has risen from 12.7% to 20.8% from 2001/02 to 2012-13. According to Pakistan's population and demographic health survey, the prevalence of C-sections has increased from 2.7% in 1990-91 to 15.8% in 2012-13. Subsequently, obstetric haemorrhage continues to be a major cause of maternal morbidity and mortality.
Objective: To compare the mean intra-operative blood loss in cesarean delivery in patients treated with combined oxytocin misoprostol versus oxytocin alone.
Study Design: A randomized controlled trial
Place And Duration: This study was conducted in Jinnah Hospital, Lahore from November 2021 to April 2022
Methodology: A total of 170 patients were inducted, 85 of them in group A were treated with oxytocin alone 85 in group B were treated with oxytocin plus misoprostol after cesarean section. The patients in Group A were given 10 IU of oxytocin intravenously and then 20 IU were added in 1000ml ringer lactate and were transfused at the rate of 1000 cc/hour. However, in group B, the patients were given oxytocin in the same way but after the delivery of the placenta, they were also given a 400-microgram sublingual misoprostol tablet.
Results: The mean age of the patients was 29.4±5.2 years. The majority (n=105, 61.8%) of the women were aged between 18-29 years with 65 (38.2%) women aged 30 years and above. The change in blood pressure ranged from 10 mmHg to 25 mmHg with a mean of 17.3±4.9 mmHg. The parity of the subjects ranged from 2 to 5 with a mean of 3.3±1.1. Out of 170, 95 (55.9%) women had a parity between 2 to 3 while 75 (44.1%) women had a parity of 4 to 5. The duration of the surgical procedure ranged from 32 to 68 minutes with a mean of 49.6±9.6 minutes. The amount of blood was significantly lesser in women receiving additional misoprostol with oxytocin as compared to oxytocin alone (537.53±29.09 vs. 646.84±21.99 ml; p-value<0.001).
Conclusion: Sublingual misoprostol was found to be superior to the standard practice of oxytocin alone in reducing intra-operative blood loss in women undergoing caesarean delivery
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