Placebo-controlled randomized comparison of vaginal with rectal misoprostol in the prevention of postpartum hemorrhage.
OBJECTIVE
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-microg misoprostol tablets (crushed and suspended in a microenema) intravaginally, or 400-microg 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 microg following placental separation was not effective for decreasing postpartum bleeding in women without excessive hemorrhage.
Ozkaya
Okan
O
Department of Obstetrics and Gynecology, School of Medicine, Suleyman Demirel University, Isparta, Turkey.
Sezik
Mekin
M
Kaya
Hakan
H
Desdicioglu
Raziye
R
Dittrich
Ralf
R
D000282:Administration, Intravaginal; D000285:Administration, Rectal; D000328:Adult; D005260:Female; D006400:Hematocrit; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D016595:Misoprostol / Q000008:administration & dosage*; D010120:Oxytocics / Q000008:administration & dosage*; D006473:Postpartum Hemorrhage / Q000097:blood / Q000517:prevention & control*; D011247:Pregnancy; D011446:Prospective Studies; D018709:Statistics, Nonparametric
D006454:Hemoglobins; D010120:Oxytocics; D016595:Misoprostol