International Journal of Contemporary Surgery
  • Year: 2014
  • Volume: 2
  • Issue: 2

A Randomized Controlled Trail of Sublingual Misoprostol Versus Oxytocin in Active Management of the Third Stage at Caesarean Section

1Assistant Professor, Department of Obstetrics and Gynaecology, Saraswathi Institute of Medical Sciences, Hapur, U.P.

2Assistant Professor, Department of Anaesthesia, Saraswathi Institute of Medical Sciences, Hapur, U.P.

3Sr. Resident, Department of Obstetrics and Gynaecology, Saraswathi Institute of Medical Sciences, Hapur, U.P.

Online published on 16 September, 2014.

Abstract

The study was conducted to compare the average blood loss and side effects in Sublingual Misoprostol (400 μgm) versus Oxytocin (10 units intravenous) groups during caesarean section after the extraction of the baby.

Randomized clinical trial was performed on 100 women to receive either sublingual misoprostol or oxytocin for the prevention of postpartum haemorrhage.

The mean blood loss was less in misoprostol group (503.40ml) in comparison to oxytocin group (576.60 ml) but it was statistically insignificant. The mean Hb level at the time of admission and 48 hours after the caesarean section was comparable between the two groups (P value- 0.515 and 0.683). There was no statistical difference in fall in Hb level following caesarean section among both the groups (9.2008% Vs 9.4928%, P value- 0.718). The incident of postpartum haemorrhage between Group I (0%) and Group II (6%) was not statistically significant. (P value- 0.242). Vomiting, diarrhea, fever, shivering and metallic taste were the more common side effects in misoprostol group, out of which fever and chills were statistically significant (P value- 0.041 and 0.028) and metallic taste was highly significant (P value- 0.006).

Sublingual misprostol appears to be safe and as effective as Oxytocin in reduction of intra-operative blood loss during caesarean section under regional anaesthesia. In addition, because of its relatively lower cost, thermostability, simple storage requirement, long shelf life and ease of administration, misoprostol may be particularly useful in developing countries as an alternative to Oxytocin.