Oral misoprostol in the prevention of uterine bleeding after surgical evacuation of first trimester abortion: A comparative study of three uterotonic agents

Abstract

Objective: This comparative study was aimed at determining the effectiveness of oral Misoprostol compared with intravenous Ergometrine and intravenous Oxytocin in reducing vaginal bleeding following surgical evacuation for first trimester abortions.
Materials and Methods: This was a single‑blind placebo‑controlled study in which patients with first trimester uncomplicated abortions were divided into three groups using computer‑generated randomization table. The first group was administered oral Misoprostol, the second group had intravenous Ergometrine, and the third group was administered intravenous Oxytocin. The uterotonic agents were administered before the surgical evacuation was carried out.
Results: There was statistically significant reduction in blood loss after the evacuation in the Misoprostol group (P < 0.000). There was also significant reduction in the number of days of bleeding in the Misoprostol group (2.00 ± 0.86) compared with 4.43 ± 0.92 and 4.64 ± 1.06 days in the Ergometrine and Oxytocin groups, respectively (P < 0.000). There were, however, more gastrointestinal side effects in the Misoprostol and Ergometrine groups (60.7% and 57.1%, respectively) compared with the Oxytocin group.
Conclusion: Oral Misoprostol appeared to demonstrate superior efficacy in reducing uterine bleeding after surgical evacuation, compared to the other commonly used uterotonic agents.

Key words: Abortion, first trimester, misoprostol, uterotonic agents, uterine bleeding