title: The effect of post-cesarean rectal misoprostol on intestinal motility.
abstract: OBJECTIVE
  To determine whether rectally administered misoprostol can induce intestinal motility compared with oxytocin infusion when used to prevent primary postpartum hemorrhage after cesarean delivery.
  
  
  METHODS
  In a prospective randomized double-blind study in Nigeria, 218 parturients undergoing cesarean delivery who had risk factors for primary postpartum hemorrhage were enrolled between July 1, 2010, and March 31, 2011. Participants received 600 μg of rectal misoprostol or 20 intravenous units of oxytocin for 4 hours after surgery. The primary outcome was time until passage of flatus. Adverse effects, need for additional analgesic, and length of hospital stay were also assessed.
  
  
  RESULTS
  The misoprostol group had a significantly shorter mean postoperative interval to passage of flatus (20.27 ± 7.77 hours versus 38.34 ± 10.98 hours; P<0.001) and commencement of regular diet (21.08 ± 7.69 hours versus 39.13 ± 10.94 hours; P<0.001). Gastrointestinal adverse effects were more frequent, albeit not significantly, in the misoprostol group: nausea, 6.4% versus 1.8%; vomiting, 7.3% versus 2.8%; and abdominal distension, 3.7% versus 2.8%. The need for additional analgesic was the same in the 2 groups.
  
  
  CONCLUSIONS
  After cesarean delivery, rectal misoprostol had the added benefit of inducing intestinal motility. Misoprostol might be considered in a clinical setting where postoperative ileus is anticipated.
authors.affiliation: Department of Obstetrics, Gynecology and Perinatology, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria.
authors.forename: Abiodun I
authors.initials: AI
authors.lastname: Adanikin
authors.forename: Ernest O
authors.initials: EO
authors.lastname: Orji
authors.forename: Olusola B
authors.initials: OB
authors.lastname: Fasubaa
authors.forename: Uche
authors.initials: U
authors.lastname: Onwudiegwu
authors.forename: Omotade A
authors.initials: OA
authors.lastname: Ijarotimi
authors.forename: Oluwaseyi
authors.initials: O
authors.lastname: Olaniyan
mesh_terms: D000285:Administration, Rectal; D000328:Adult; D002585:Cesarean Section; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D005769:Gastrointestinal Motility / Q000187:drug effects*; D006801:Humans; D007262:Infusions, Intravenous; D007902:Length of Stay; D016595:Misoprostol / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D009549:Nigeria; D010120:Oxytocics / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D010121:Oxytocin / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D010865:Pilot Projects; D011183:Postoperative Complications / Q000517:prevention & control; D006473:Postpartum Hemorrhage / Q000517:prevention & control; D011247:Pregnancy; D011446:Prospective Studies; D013997:Time Factors; D055815:Young Adult
chemical_list: D010120:Oxytocics; D016595:Misoprostol; D010121:Oxytocin