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RETRACTED ARTICLE: Rectal vs. sublingual misoprostol before cesarean section: double-blind, three-arm, randomized clinical trial

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

This article was retracted on 12 March 2024

This article has been updated

Abstract

Purpose

The commonest surgical procedure for women is cesarean delivery. Postpartum hemorrhage and intra-operative blood during cesarean delivery is a major concern to all obstetricians. This study was conducted to assess the efficacy of the adjuvant use of misoprostol and oxytocin in decreasing intra-operative blood loss in cesarean delivery.

Methods

This was a double-blinded randomized clinical trial including 636 term pregnant woman scheduled for cesarean section at Ain Shams University Maternity Hospital, Cairo, Egypt, between February 2013 and February 2014. Participants received either 400-μg misoprostol rectally or sublingually or placebo before cesarean section together with 5-IU oxytocin IV. The main outcome measure was intra-operative blood loss. Difference between the three groups was analyzed using one-way ANOVA test (for numeric variables) and Chi-square test (for categorical variables). P < 0.05 was considered statistically significant.

Results

Intra-operative blood loss was higher in patients who did not receive misoprostol (Placebo Group) (295–1075 ml, 641.7 ± 135.7) than those who received it, regardless the route of administration, rectal (135–830 ml, 457.5 ± 140.7; P < 0.001), and sublingual (135–680 ml, 357.8 ± 129.7; P < 0.001). In addition, sublingual route was associated with significantly lower estimated intra-operative blood loss compared to rectal administration (P < 0.001).

Conclusions

Misoprostol with oxytocin is an effective drug-combination for decreasing intra-operative blood loss during cesarian section with clinical superiority to sublingual over rectal route.

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Acknowledgements

This work was supported by Ain-Shams University.

Funding

This study did not receive any funds from any organization.

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Authors and Affiliations

  1. Obstetrics and Gynecology Department, Ain Shams University, Cairo, 16646, Egypt

    Mohamed S. Sweed, Mourad M. El-Saied, Amgad E. Abou-Gamrah, Haitham A. El-Sabaa, Mohamed M. Abdel-Hamid, Hossam Hemeda, Ahmed M. Mansour, Mohamed E. Shawky, Medhat A. El-Sayed & Radwa M. Mohamed

Authors
  1. Mohamed S. Sweed
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  2. Mourad M. El-Saied
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  3. Amgad E. Abou-Gamrah
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  4. Haitham A. El-Sabaa
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  5. Mohamed M. Abdel-Hamid
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  6. Hossam Hemeda
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  7. Ahmed M. Mansour
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  8. Mohamed E. Shawky
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  9. Medhat A. El-Sayed
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  10. Radwa M. Mohamed
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Contributions

MS: protocol/project development, data analysis, and manuscript writing/editing. ME-S: protocol/project development. AA-G: protocol/project development. HE-S: data collection or management. MA-H: data collection or management. HH: data collection or management. AMM: data collection or management. MES: data collection or management. MAE-S: data collection or management. RMM: data collection or management.

Corresponding author

Correspondence to Mohamed S. Sweed.

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Conflict of interest

All authors declare no conflict of interests.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Approval was obtained from the ethical committee of the Department of Obstetrics and Gynecology, Ain-Shams University (Approval Number: 3458).

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Sweed, M.S., El-Saied, M.M., Abou-Gamrah, A.E. et al. RETRACTED ARTICLE: Rectal vs. sublingual misoprostol before cesarean section: double-blind, three-arm, randomized clinical trial. Arch Gynecol Obstet 298, 1115–1122 (2018). https://doi.org/10.1007/s00404-018-4894-2

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  • DOI: https://doi.org/10.1007/s00404-018-4894-2

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