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Objective: To compare the effectiveness of sublingual misoprostol in reducing intraoperative and postoperative blood loss with that of intravenous (IV) oxytocin infusion in first two hours at caesarean delivery. Methods: It was randomized controlled trial. Study was conducted in Lady Aitchison Hospital, Lahore unit IV-King Edward Medical University and duration of study was one year. Eighty-two women with term singleton pregnancy undergone elective cesarean section under spinal anesthesia were randomly allocated to receive either misoprostol 400 μg sublingually or IV infusion of 20 units oxytocin in 1000ml of normal saline soon after delivery of the baby. Estimated blood loss at surgery and within the first 2 h post-operation was measured in both groups. Side effects in both groups were also recorded. Results: Mean blood loss with misoprostol was significantly less as compared to that of oxytocin. Post-operative hemoglobin was decreased by -4.95% in sublingual misoprostol and in oxytocin group it was decreased by -9.33%. Blood transfusion and additional uterotonic therapy was significantly higher in oxytocin group as compared to that of misoprostol. Nausea, vomiting and hypotension was significantly higher in oxytocin group as compared to that of misoprostol group. On the other hand, pyrexia and shivering was significantly higher in misoprostol group. Conclusion: Results of this trial showed that sublingual misoprostol is more effective as compared to intravenous oxytocin infusion in terms of reduction of blood loss in first two hours at caesarean section. It offers several advantages over oxytocin including long shelf life, stability at room temperature and oral administration which makes it suitable uterotonic agent in low-resource areas.

pakistan postgraduate medical institute

A COMPARISON OF THE EFFECTIVENESS OF SUBLINGUAL MISOPROSTOL VERSUS INTRAVENOUS OXYTOCIN INFUSION IN REDUCING BLOOD LOSS IN FIRST TWO HOURS AT CAESAREAN SECTION