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Placebo-controlled randomized comparison of vaginal with rectal misoprostol in the prevention of postpartum hemorrhage

Authors

  • Okan Ozkaya,

    1. Department of Obstetrics and Gynecology, School of Medicine, Suleyman Demirel University, Isparta, Turkey; and
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  • Mekin Sezik,

    1. Department of Obstetrics and Gynecology, School of Medicine, Suleyman Demirel University, Isparta, Turkey; and
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  • Hakan Kaya,

    Corresponding author
    1. Department of Obstetrics and Gynecology, School of Medicine, Suleyman Demirel University, Isparta, Turkey; and
      Dr Hakan Kaya, Department of Obstetrics and Gynecology, School of Medicine, Suleyman Demirel University, 32260 Isparta, Turkey. Email: drhakankaya2002@yahoo.com
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  • Raziye Desdicioglu,

    1. Department of Obstetrics and Gynecology, School of Medicine, Suleyman Demirel University, Isparta, Turkey; and
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  • Ralf Dittrich

    1. Department of Obstetrics and Gynecology, University of Erlangen-Nuremberg, Erlangen, Germany
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Dr Hakan Kaya, Department of Obstetrics and Gynecology, School of Medicine, Suleyman Demirel University, 32260 Isparta, Turkey. Email: drhakankaya2002@yahoo.com

Abstract

Aim: To compare vaginally administered misoprostol to rectally administered misoprostol and placebo in a prospective randomized placebo-controlled study.

Methods: One hundred and fifty women with singleton vaginal deliveries were randomized (50 women in each arm) to receive 400-µg misoprostol tablets (crushed and suspended in a microenema) intravaginally, or 400-µg misoprostol tablets rectally, or two placebo lactose tablets rectally. The medication was administered immediately after delivery of the placenta. Women with profuse hemorrhage and delayed placental separation (>30 min) were excluded. Our outcome measures were postpartum blood loss 1 h after administration, and change in hemoglobin and hematocrit values from baseline to postpartum day 1. Analysis of variance and chi-squared tests were used to compare the outcome variables between groups.

Results: One hundred and twenty-six women were available for analysis. Baseline characteristics were similar across the groups. The number of excluded subjects, the estimated blood loss, and the drop in hemoglobin and hematocrit values did not differ between the three groups (P > 0.05).

Conclusions: Misoprostol administered vaginally or rectally at a dosage of 400 µg following placental separation was not effective for decreasing postpartum bleeding in women without excessive hemorrhage.

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