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Abstract
Background: Postpartum hemorrhage (PPH) ranks among the causes of maternal morbidity and mortality, and is a significant issue with cesarean delivery. Uterine atony is the other major cause of excessive blood loss, and other uterotonic drugs could help increase uterine tone and decrease perioperative blood loss.
Objective: To compare the mean blood loss with intrauterine misoprostol with intravenous oxytocin and intravenous oxytocin alone during cesarean section.
Methods: This was a randomized controlled trial that was carried out at Department of Obstetrics and Gynecology, POF hospital, Wah Cantt from April 2025 to July 2025. A total of 60 women in lower segment cesarean section were randomly divided into two groups of equal numbers. Group A got 10 IU intravenous oxytocin, and Group B got 10 IU intravenous oxytocin plus 400 µg intrauterine misoprostol upon delivery of the placentas. Intraoperative and 24-hour postoperative blood loss was measured by gravimetric and volumetric methods. SPSS version 25 was used for analysis of data.
Results: Mean intraoperative blood loss was lower in Group B than Group A (310.2 ± 38.6 vs. 380.5 ± 45.2 mL). Similarly, 24-hour postoperative blood loss was lower in Group B (112.4 ± 18.3 vs. 145.2 ± 22.1 mL). Total measured blood loss was 422.6 ± 43.1 mL in Group B compared with 525.7 ± 52.4 mL in Group A (p < 0.001).
Conclusion: In this study, the postoperative bleeding volume was significantly decreased in the group receiving intrauterine misoprostol in addition to intravenous oxytocin during cesarean section.