The Effect of a Single Preoperative Dose of Sublingual Misoprostol in Reducing Intraoperative Blood Loss after Total Abdominal Hysterectomy: A Single-Blind Randomized Controlled Trial

Background & Objective: Postoperative hemorrhage is one of the most frequently cited complications of total abdominal hysterectomy (TAH). This study aimed to investigate the effect of a single preoperative dose of sublingual misoprostol on reducing blood loss during total abdominal hysterectomies. Materials & Methods: This study was a single-blind randomized controlled trial (RCT). The statistical population included all women who were candidates of hysterectomy in 2017 and 2018. A total of 132 patients were randomly selected and classified into two groups of misoprostol (N=66) and placebo (N=66). Examining intraoperative blood loss was considered a primary outcome. Moreover, levels of hemoglobin before and 24 hours after the surgery, the need for a blood transfusion, febrile morbidity, and the duration of hospitalization were regarded as secondary outcomes. The means of bleeding in the two groups were compared using a t-test. Results: There were no significant differences between the two groups in the baseline characteristics (P<0.05). After the surgery, the mean of hemoglobin values was lower in the placebo group compared to the misoprostol one, and this difference was statistically significant (P<0.001). There was a significant difference in intraoperative blood loss between the two groups, and it was significantly higher in the placebo group (P<0.001). Conclusion: Taking a single preoperative dose of sublingual misoprostol is effective in reducing intraoperative blood loss after total abdominal hysterectomies. Additionally, this intervention led to a decline in hemoglobin.

Keywords:

Misoprostol , Hysterectomy , Post Hysterectomy Hemorrhage , Randomized Controlled Trial