Sublingual Misoprostol Prior to Caesarean Section-Randomized Controlled Trial

Document Type : Original Article

Authors

Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

10.21608/aimj.2025.446595

Abstract

Background: Most severe maternal morbidities, including need for blood transfusions, extended hospital stays, and surgeries that may impair reproductive function, are caused by postpartum hemorrhage (PPH).
Aim and objectives: To evaluate the effectiveness and safety of sublingual misoprostol prior to cesarean section (CS) in decreasing intraoperative blood loss and uterine atony at cesarean delivery.
Subjects and methods: 100 women who gave birth by caesarean section at the Obstetrics and Gynecology Department (Al-hussein) at Al-Azhar University Hospital participated in this randomized controlled clinical research, which ran from November 2023 to December 2024. There were two equal groups of patients.
Results: Group I experienced a significantly lower blood loss (ml) at 1 hour, 4 hours, and 24 hours following delivery than Group II. 10.0% of the individuals in Group I required additional uterotonics, whereas 20.0% of the individuals in Group II required such assistance. Group I and Group II did not differ statistically significantly in terms of the requirement for blood transfusions, further uterotonics, or vaginal bleeding exceeding 1000 milliliters.
Conclusion: Misoprostol administered sublingually may be a superior choice due to its quick absorption, extended duration of action, and highest overall bioavailability.

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