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The Effect of Combined Oxytocin–Misoprostol Versus Oxytocin and Misoprostol Alone in Reducing Blood Loss at Cesarean Delivery: A Prospective Randomized Double-Blind Study

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Abstract

Purpose

To compare the effect of combined oxytocin–misoprostol versus oxytocin and misoprostol alone in reducing blood loss at cesarean delivery.

Methods

One hundred fifty patients of 18–40 years with singleton term pregnancies scheduled for cesarean section under spinal anesthesia were recruited in a prospective double-blind randomized clinical trial to one of the three following groups to receive 20 IU infusion of oxytocin (group O), 400-µg sublingual misoprostol tablets (group M) or 200-µg misoprostol plus 5 IU bolus intravenous oxytocin (group MO) after delivery. The hemoglobin level before surgery and 24 h after surgery, the need for additional oxytocic therapy, and the incidence of adverse effects were recorded.

Results

The mean blood loss during surgery was significantly lower in group MO compared to other groups (P = 0.04). Comparison of mean arterial pressure (P = 0.38) and heart rate (P = 0.23) changes during spinal anesthesia and surgery failed to reveal any statistically significant differences between all groups through repeated measure analysis.

Conclusion

The use of combined lower dose of misoprostol–oxytocin significantly reduced the amount of blood loss during and after the lower segment cesarean section compared to higher dose of oxytocin and misoprostol alone, and its use was not associated with any serious side effects.

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Compliance with ethical requirements and Conflict of interest

The research proposal of this study has been reviewed by the Medical Research Ethical Committee of the Qazvin University of Medical Science and there is no conflict with ethical consideration (date: 23/June/2012). The authors of this paper have not declared any conflicts of interest.

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Faculty of Medicine, Qazvin University of Medical Sciences, Shahid Bahonar Ave., PO Box 3419759811, Qazvin, Iran

    Hamideh Pakniat (Assistant Professor)

  2. Department of Anesthesiology, Faculty of Medicine, Qazvin University of Medical Science, Shahid Bahonar Ave., PO Box 3419759811, Qazvin, Iran

    Marzieh Beigom Khezri (Associate Professor)

Authors
  1. Hamideh Pakniat
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  2. Marzieh Beigom Khezri
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Corresponding author

Correspondence to Marzieh Beigom Khezri.

Additional information

Registration number: ACTRN12612000095864 and ClinicalTrials.gov Identifier: NCT01571323

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Pakniat, H., Khezri, M.B. The Effect of Combined Oxytocin–Misoprostol Versus Oxytocin and Misoprostol Alone in Reducing Blood Loss at Cesarean Delivery: A Prospective Randomized Double-Blind Study. J Obstet Gynecol India 65, 376–381 (2015). https://doi.org/10.1007/s13224-014-0607-3

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  • DOI: https://doi.org/10.1007/s13224-014-0607-3

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