Comparison of rectal misoprostol's effect when used before and after a cesarean section on post-cesarean bleeding.

OBJECTIVE: Cesarean section is a common surgery in women. Different drugs are used to control its bleeding. This study compared the effect of using rectal misoprostol before and after surgery on the amount of post-cesarean bleeding.

MATERIALS AND METHODS: A number of 120 women who were admitted to our hospital because of elective cesarean section entered this clinical trial. They were divided into two groups. The first (before surgery) group received 400μg of rectal misoprostol before the cesarean section and the second (after surgery) group after the surgery. The amount of bleeding was measured in both groups. The data were recorded and analyzed.

RESULTS: Their mean of age was 29.1±6.1 years old. The mean of blood loss volume was 283±147mL in the before-surgery group and 294±108mL in the after-surgery group (P=0.6). There was no significant difference in the level of post-operation hemoglobin between the two groups. However, the frequency of need for additional uterotonics was 47% in the first group and 85% in the second group (P<0.001).

CONCLUSION: There seems to be no significant difference in administering rectal misoprostol before or after the surgery, but the need for additional uterotonics is reduced if it is used before the surgery.