Misoprostol for Reduction of Intra-operative Blood Loss in Women Delivered by Elective Cesarean Section Randomized Controlled Trial

Abstract

Postpartum hemorrhage continues to be the leading cause of maternal morbidity and mortality worldwide according to estimate of the World Health Organization in 2008.It is traditionally defined as blood loss greater than 500 mL during a vaginal delivery or greater than 1,000 mL with a cesarean delivery. Uterine atony is the most common cause of immediate heavy PPH. A reduction of operative blood loss at cesarean section is beneficial to the patients in terms of decreased post-operative morbidity and a decrease in risks associated with blood transfusion. The routine use of oxytocin is associated with a significant reduction in the occurrence of postpartum hemorrhage. Misoprostol is an easy alternative to be used for the prevention of postpartum hemorrhage being used via multiple routes and is heat stable and also inexpensive; hence comes its importance in preventing postpartum hemorrhage. The main objective of this study was to evaluate and compare the efficacy of the rectal PGE1 synthetic analogue (misoprostol) 400 microgram given peri-cesarean section to decrease intra-operative blood loss during the operation.