Background:Blood loss is one of the important complications during cesarean section
(CS). Previous reports have shown that misoprostol is effective in reducing
blood loss during and after CS. However, the optimum time for its
administration to decrease the amount of PPH is still under discussion. Objective: To compare the effect of preoperative and postoperative administration of
sublingual misoprostol (400 μg) in reducing the amount of blood loss during and
24 hours after CS. Setting: Obstetrics and Gynecology Department,
Faculty of Medicine, Assiut University, Assiut, Egypt, between January 2017 and
July 2018. Study Design: A prospective, randomized clinical trial. Methods: Four-hundred thirty women fulfilling the inclusions criteria: elective lower
segment CS at term (≥37 weeks) with normal fetal heart tracing who accepted to
participate in the study. Patients were divided into two groups;Patients
assigned to group 1 received 400 μg sublingual misoprostol immediately after
urinary catheterization and before skin incision, while patients assigned to
group 2 received sublingual misoprostol immediately after skin closure. The
primary outcome was the estimation of intraoperative and postoperative blood
loss for 24 hours. Results: There was a significant reduction in the
intraoperative blood loss in group 1 compared with group 2 (403.51 ± 72.99 vs.
460.99 ± 74.66 ml, respectively). Also, there was a significant reduction in
postoperative blood loss in group 1 compared with group 2 with a statistical
significance (169.45 ± 12.03 vs. 195.77 ± 13.34 ml, respectively).Postoperative
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