• Am. J. Obstet. Gynecol. · May 2005

    Randomized Controlled Trial Clinical Trial

    Buccal misoprostol to prevent hemorrhage at cesarean delivery: a randomized study.

    • Jennifer Hamm, Zoi Russell, Tracey Botha, S J Carlan, and Kris Richichi.
    • Arnold Palmer Hospital for Children and Women, Orlando, Fla, USA.
    • Am. J. Obstet. Gynecol. 2005 May 1;192(5):1404-6.

    ObjectiveThe purpose of this study was to assess the efficacy of buccal misoprostol to decrease uterine atony, hemorrhage, and the need for additional uterotonic agents during cesarean delivery.Study DesignPatients who underwent cesarean delivery were assigned randomly to either 200-microg misoprostol or placebo placed in the buccal space. A dilute intravenous oxytocin infusion was given to all patients at delivery of the placenta. The primary outcome variable was the need for additional uterotonic agents.ResultsA total of 352 women received random assignments. Demographic and intrapartum characteristics were similar between the groups. More women in the placebo group required 1 additional uterotonic agent (43% vs 26%; P < .01; relative risk, 1.3; 95% CI, 1.10, 1.50). There was not a difference between the groups in the incidence of postpartum hemorrhage or a difference in preoperative and postoperative hemoglobin level.ConclusionBuccal misoprostol reduces the need for additional uterotonic agents during cesarean delivery.

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