The Effect of Combined Oxytocin and Sublingual Misoprostol in Reducing Blood loss During and After Cesarean Delivery:A Randomized Clinical Trial

سال انتشار: 1398
نوع سند: مقاله کنفرانسی
زبان: انگلیسی
مشاهده: 340

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شناسه ملی سند علمی:

COBGY15_042

تاریخ نمایه سازی: 11 آبان 1398

چکیده مقاله:

Background: Postpartum hemorrhage is one of the main causes of maternal morbidity and mortality in developing countries .Cesarean section is one of the most common surgery in all around the world. In comparison with normal vaginal delivery, cesarean section is a grater risk factor for post partum hemorrhage and need for blood transfusion. The risk of post partum hemorrhage increase when other risk factors such as; multiple pregnancy, polyhydramnios, severe preeclampsia, peripartum hemorrhage, protracted labor, labor induction and obesity are present. Oxytocin is conventionally used for prevention of uterine atony during cesarean section. This study was performed with aim to evaluate the effect of combination of oxytocin and sublingual misoprostol in reducing blood loss during and after cesarean delivery.Methods: This randomized clinical trial was performed in Ommolbanin hospital which is an academic hospital and affiliated to Mashhad university of medical sciences, on 90 pregnant women with term pregnancy who were candidate for emergent cesarean delivery with spinal anesthesia and were high risk for post partum hemorrhage from September 2016 to January 2018 . All participants received 40 IU oxytocin in 1 liter of normal saline after delivery , then Participants were randomly assigned to intervention group who received 400 μg sub lingual misoprostol in combination with oxytocin infusion and control group who received only oxytocin infusion without adding misoprostol.Results: Adding sublingual misoprostol in combination with oxytocin infusion during cesarean section was led to significantly decrease the postoperative blood loss during six hours after surgery (P<0.001). Decline in the hemoglobin and hematocrit levels and the amount of intra operative hemorrhage were the same in both groups. Less additional uterotonic agents were needed in misoprostol group. The frequency of fever and other side effects were similar in both groups.Conclusion: It seems that; among high risk women for postpartum hemorrhage, adding of sublingual misoprostol to oxytocin infusion is more effective to reduce blood loss during and after cesarean section

نویسندگان

Leila Pourali

Department of Obstetrics and Gynecology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.