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Active management of the third stage at Caesarean section: a randomised controlled trial of misoprostol versus Syntocinon
Author(s) -
Lokugamage AU,
Paine M,
BassawBalroop K,
Sullivan KR,
Refaey H El,
Rodeck CH
Publication year - 2001
Publication title -
australian and new zealand journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.734
H-Index - 65
eISSN - 1479-828X
pISSN - 0004-8666
DOI - 10.1111/j.1479-828x.2001.tb01319.x
Subject(s) - uterotonic , misoprostol , caesarean section , medicine , shivering , placebo , obstetrics , anesthesia , randomized controlled trial , blood loss , bolus (digestion) , blood transfusion , pregnancy , surgery , oxytocin , abortion , alternative medicine , pathology , biology , genetics
SUMMARY The objective of this trial was to investigate whether 500 ug oraJ misoprostol given immediately after delivery of the neonate at Caesarean section is as effective as a bolus intravenous injection of 10 iu Syntocinon in stimulating uterine contractions and thereby reducing blood loss. Forty women undergoing elective or emergency Caesarean section were included in a placebo‐controlled randomised trial. Group 1 received oral misoprostol and a placebo intravenous bolus and Group 2 received intravenous Syntocinon and oral placebo tablets. The main outcome measures were estimated blood loss at Caesarean section, drop in serum haemoglobin, and the need for additional uterotonic agents. We found that there was no significant difference (p = 0.75) in estimated blood loss between the two groups. No differences were observed in the decrease in haemoglobin, requirement for additional oxytocics, the need for blood transfusion or the degree of shivering in each group (p > 0.05 in each case). We concluded that oral misoprostol could be used as an alternative oxytocic agent for the third stage at Caesarean section. However, there is an obvious need for a larger randomised controlled trial to be undertaken. Previous published studies have concentrated on vaginal births and further studies should be extended to Caesarean deliveries.