Akademik Veri Yönetim Sistemi
Jinekoloji ve Obstetrik Dergisi, cilt.17, sa.4, ss.218-223, 2003 (Scopus, TRDizin)
OBJECTIVE: To investigate the efficacy of rectal misoprostol in preventing postpartum hemorrhage with comparison to the standard regimen with oxytocin and metil ergonovine. STUDY DESIGN: In a randomized-controlled design, the study was performed prospectively between 1.1.2002-31.6.2002 in Istanbul University Cerrahpasa School of Medicine, Department of Obstetrics and Gynecology. The cases fulfilling the criteria for the study admission were divided into study and control groups in a block randomization scheme. The patients were administered 400 μg misoprostol rectally and 0.9 % saline solution (100 cc/h infusion rates) intravenously in the study group as soon as the umbilical cord was clamped. In the control group, 10 IU oxytocin and 0.2 mg methylergonovine were administered intramuscularly and 0.9 % saline solution intravenously (standard regimen for prevention of postpartum hemorrhage). The study group composed of 49 patients and 48 patients served as controls. The amount of bleeding was measured and the changes in the blood count parameters were evaluated. Statistical analysis was performed using chi-square. Fischer's exact test. Student t-test and Pearson correlation analysis. p<0.05 was accepted as statistically significant. RESULT(s): The total amount of bleeding was found to be more and the decrease in the Hb values was more prominent (1.28±0.73 g/dl vs 1.75±0.73. p<0.001) in the study group. In the study group. 13 cases out of 49 were detected to have Hb values below 10.0 g/dL while in the control group, this was 18 patients out of 48 (p<0.05). In a further analysis, 23 patients were found to bleed over 500 cc in the study group (23/49) while it was 11 patients among the controls (11/48) (p<0.05). CONCLUSION(s): Rectal misoprostol administration does not seem to be superior to the standard regimen of oxytocin and methylergonovine for preventing postpartum hemorrhage. It may be an alternative for the standard regimen when the standard medications are not available or the patient is irresponsive to other medications and should be reserved for these situations rather than being a first-line-treatment in the control of postpartum hemorrhage.