Department of Obstetrics and Gynecology, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
Int J Gynaecol Obstet. 2012 Aug;118(2):149-52. doi: 10.1016/j.ijgo.2012.03.038. Epub 2012 Jun 13.
To evaluate the effect of preoperative administration of rectal misoprostol on blood loss during and after elective cesarean delivery.
A randomized controlled trial was conducted among 400 women scheduled for elective cesarean delivery. The study group (n=200) received 400 μg of misoprostol. The control group (n=200) received placebo. Study medications were administered rectally after catheter insertion and shortly before skin incision. The main outcome measures were intra-operative blood loss, postpartum blood loss at 24 hours, and difference between preoperative and postoperative hematocrit values.
The mean intra-operative and postpartum blood loss was significantly lower in the study group than the control group: 429 ± 234 mL and 185 ± 95 mL versus 620 ± 375 mL and 324 ± 167 mL, respectively (P=0.001 for both comparisons). The difference between the preoperative and postoperative hematocrit values was also significantly lower in the study group than the control group (4.62 ± 2.45 versus 8.15 ± 3.84; P=0.02). Admissions to the neonatal intensive care unit and Apgar scores at 1 and 5 minutes were comparable between the 2 groups.
Preoperative treatment with 400 μg rectal misoprostol significantly reduced blood loss related to elective cesarean delivery.
评估术前直肠给予米索前列醇对选择性剖宫产术中及术后出血量的影响。
一项随机对照试验纳入了 400 例行择期剖宫产的妇女。研究组（n=200）给予 400μg米索前列醇，对照组（n=200）给予安慰剂。研究药物在插入导管后和皮肤切开前不久直肠给予。主要结局指标为术中失血量、产后 24 小时的产后失血量以及术前与术后血细胞比容值的差值。
研究组的术中及产后失血量明显低于对照组：分别为 429±234ml 和 185±95ml 与 620±375ml 和 324±167ml（两者比较均 P=0.001）。研究组术前与术后血细胞比容值的差值也明显低于对照组（分别为 4.62±2.45 与 8.15±3.84；P=0.02）。两组新生儿重症监护病房的入住率和 1 分钟及 5 分钟时的 Apgar 评分相当。
术前给予 400μg直肠米索前列醇可显著减少择期剖宫产的出血量。
