Department of Obstetrics and Gynecology, Faculty of Medicine, Cairo University, Cairo, Egypt.
Int J Gynaecol Obstet. 2021 Apr;153(1):113-118. doi: 10.1002/ijgo.13426. Epub 2020 Nov 6.
To compare the efficacy and safety of rectal misoprostol with intrauterine misoprostol in the reduction of blood loss during and after cesarean delivery.
Ninety-eight pregnant women, all candidates for elective cesarean delivery, were equally randomized into two groups: the rectal group (received preoperative misoprostol rectally) and the intrauterine group (received intrauterine misoprostol after the delivery of the placenta). The primary outcome was the estimated blood loss (EBL) during cesarean delivery. Secondary outcomes included the occurrence of excessive blood loss (>1000 mL) within the first 24 hours postoperatively and the occurrence of any maternal or fetal side effects.
There were no statistically significant differences between the two groups regarding either the EBL (693.12 ± 139.09 vs 692.39 ± 132.83; P=0.979) or the occurrence of postpartum hemorrhage (>1000 mL) (6.1% vs 4.1%; P=0.99. Apgar scores at 1 and 5 minutes were significantly higher in the intrauterine group compared to the rectal group.
Insertion of intrauterine misoprostol is as effective as rectal insertion in reducing blood loss during and after cesarean delivery; however, it has a safer neonatal outcome and is more convenient when administered during cesarean delivery. ClinicalTrials.gov: NCT03723031.
比较直肠米索前列醇与宫腔内米索前列醇在减少剖宫产术中及术后出血量方面的疗效和安全性。
98 例择期剖宫产孕妇，随机分为两组：直肠组（术前直肠给予米索前列醇）和宫腔内组（胎盘娩出后宫腔内给予米索前列醇）。主要结局是剖宫产术中估计失血量（EBL）。次要结局包括术后 24 小时内发生过多出血（>1000 mL）和任何母亲或胎儿的副作用。
两组 EBL（693.12±139.09 比 692.39±132.83；P=0.979）或产后出血（>1000 mL）（6.1%比 4.1%；P=0.99）发生率均无统计学差异。宫腔内组 1 分钟和 5 分钟时的 Apgar 评分明显高于直肠组。
宫腔内放置米索前列醇与直肠放置米索前列醇在减少剖宫产术中及术后出血量方面同样有效；但新生儿结局更安全，且在剖宫产术中给药更方便。ClinicalTrials.gov：NCT03723031。
