1 Maternity research center, KermanshahUniversity of medical sciences, Kermanshah, Iran - 2 Research committee of students, Kermanshah university of medical sciences, Kermanshah, Iran - 3 biostatistics and epidemiology dept., social development and health promotion research center, Kermanshah university of medical sciences, Kermanshah, Iran


Introduction: Up to now, no study has been done to detect the comparison of sublingual misoprostol versus oxytocin effect in reducing Hemorrhage employing doses less than 400 mg. The purpose of this study was to compare the effects of high and low doses of sublingual misoprostol with intravenous oxytocin in reducing bleeding in cesarean section deliveries.

Materials and methods: In this clinical trial, 185 women who underwent cesarean section in Imam Reza Hospital during 9 months of the 2011-12 year were selected by convenience sampling method. Patients were randomly assigned to three groups with foursome random blocks: misoprostol 400 mcg, 200 mcg misoprostol and oxytocin 20 units were conducted.

Results: The groups were matched for age, BMI and gravidity. Bleeding after delivery was significantly (P=0.003) in the oxytocin group lower and in the misoprostol 400 mcg group was higher than others. Oxytocin group (n=5), compared to the other groups had a greater need for blood transfusion (P=0.031). 400 mcg misoprostol group (n=3) were less likely to require oxytocin infusion (P=0.042). The three groups did not differ in terms of developing the complication.

Conclusion: Emergency and elective cesarean patients using sublingual misoprostol 200 mcg needs no blood transfusion. This protocol can be a safe and effective alternative to the use of sublingual misoprostol 400 mcg and 20 IU oxytocin. It is suggested that in cesarean section to reduce the need for transfusion of blood and lost blood, the prescription be taken into account. Also, in future studies to examine this issue are addressed in the high-risk population.


Misoprostol, sublingual, Oxytocin, injection, bleeding, childbirth, cesarean.