Vaginal or sublingual misoprostol before insertion of an intrauterine device in women who have previously had a cesarean section

2019 ◽  
Vol 3 (3) ◽  
pp. 661
Author(s):  
HananA.E.M Mohammed ◽  
NahedH Mohammed ◽  
YassminM.S.A El-Rahman
Keyword(s):  
Cesarean Section ◽  
Intrauterine Device ◽  
Sublingual Misoprostol

scholarly journals Intrauterine Device Insertion during Cesarean Section in Women without Prenatal Contraception Counseling: Lessons from a Country with High Cesarean Rates

2019 ◽  
Vol 41 (08) ◽  
pp. 485-492
Author(s):  
Alberto Moreno Zaconeta ◽  
Ana Carolina Oliveira ◽  
Flavielly Souza Estrela ◽  
Thalia Maia Vasconcelos ◽  
Paulo Sergio França ◽  
...  
Keyword(s):  
Cohort Study ◽  
Cesarean Section ◽  
Removal Rate ◽  
Intrauterine Device ◽  
Uterine Perforation ◽  
Cesarean Sections ◽  
Trial Of Labor ◽  
The Moment ◽  
Contraception Counseling

Objective The moment of admission for delivery may be inappropriate for offering an intrauterine device (IUD) to women without prenatal contraception counseling. However, in countries with high cesarean rates and deficient prenatal contraception counseling, this strategy may reduce unexpected pregnancies and repeated cesarean sections. Methods This was a prospective cohort study involving 100 women without prenatal contraception counseling. Postplacental IUD was offered after admission for delivery and placed during cesarean. The rates of IUD continuation, uterine perforation, and endometritis were assessed at 6 weeks and 6 months, and the proportion of women continuing with IUD at 6 months was assessed with respect to the number of previous cesareans. Results Ninety-seven women completed the follow-up. The rate of IUD continuation was 91% at 6 weeks and 83.5% at 6 months. The expulsion/removal rate in the first 6 weeks was not different from that between 6 weeks and 6 months (9 vs 9.1%, respectively). There were 2 cases of endometritis (2.1%), and no case of uterine perforation. Among 81 women continuing with intrauterine device after 6-months, 31% had undergone only the cesarean section in which the IUD was inserted, 44% had undergone 2 and 25% had undergone 3 or more cesarean sections. Conclusion Two thirds of the women who continued with IUD at 6 months had undergone 2 or more cesarean sections. Since offering trial of labor is unusual after 2 or more previous cesareans, we believe that offering IUD after admission for delivery may reduce the risk of repeated cesarean sections and its inherent risks.

Sublingual Misoprostol vs Intravenous Tranexamic Acid in reducing Blood Loss during Cesarean Section: A Prospective Randomized Study

2017 ◽  
Vol 9 (1) ◽  
pp. 9-13 ◽  
Author(s):  
Deepak Bose ◽  
Rasheeda Beegum
Keyword(s):  
Risk Factors ◽  
Blood Loss ◽  
Cesarean Section ◽  
Tranexamic Acid ◽  
Randomized Study ◽  
Operation Time ◽  
Prospective Randomized Study ◽  
Cord Clamping ◽  
Group I ◽  
Sublingual Misoprostol

ABSTRACT Introduction The increasing incidence of cesarean sections in India has caused a rise in the incidence of postpartum hemorrhage (PPH). There has been expanding interest in the role of misoprostol and tranexamic acid (TXA) in preventing and managing PPH during lower (uterine) segment cesarean section (LSCS). However, the lack of a published study comparing the efficacies of these drugs prompted us to conduct this study. Aims and objectives To compare the efficacies of sublingual misoprostol (600 μg) and intravenous TXA injection (500 mg) in reducing blood loss during LSCS by assessing intraoperative blood loss, perioperative hemoglobin (Hb) fall, and need for additional uterotonic agents. Materials and methods A total of 163 pregnant patients undergoing emergency/elective LSCS during the study period from 2013 to 2014 were randomly assigned to two groups — group I (82) received sublingual misoprostol 600 μg and group II (81) intravenous TXA 500 mg at cord clamping. Visual estimation of blood loss was done and 48 hours postoperative Hb and packed cell volume were measured to compare with preoperative values. Need for added uterotonics, blood transfusion, and adverse effects of drugs was assessed. The two groups were again subgrouped based on presence or absence of risk factors for PPH. Results The TXA significantly reduced blood loss compared with misoprostol (416 vs 505 mL) in patients without high-risk factors for PPH. Misoprostol caused significantly higher minor side effects while TXA reduced operation time. Conclusion The TXA can be routinely used after cord clamping along with oxytocin in patients undergoing elective/emergency LSCS to reduce perioperative blood loss, especially in those without risk factors for PPH. How to cite this article Bose D, Beegum R. Sublingual Misoprostol vs Intravenous Tranexamic Acid in reducing Blood Loss during Cesarean Section: A Prospective Randomized Study. J South Asian Feder Obst Gynae 2017;9(1):9-13.

scholarly journals Intrauterine Device in the Immediate Postpartum: Study Comparing Insertion after Cesarean Section and Vaginal Delivery

2019 ◽  
Vol 09 (11) ◽  
pp. 1510-1518
Author(s):  
Moussa Diallo ◽  
Hadja Maïmouna Barro Daff ◽  
Abdoul Aziz Diouf ◽  
Aminata Niass ◽  
Youssou Toure ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Vaginal Delivery ◽  
Intrauterine Device

scholarly journals A comparative, randomized study of levonorgestrel Intrauterine System (LNG-IUS) vs Copper T 380 A intrauterine device applied during cesarean section

2012 ◽  
Vol 02 (02) ◽  
pp. 151-155 ◽  
Author(s):  
José A. López-Farfan ◽  
Alicia Hernandez-Gonzalez ◽  
Irvin J. Vélez-Machorro ◽  
Leopoldo A. Vázquez-Estrada
Keyword(s):  
Cesarean Section ◽  
Intrauterine Device ◽  
Randomized Study

Complete uterus didelphia and stage 3 genital prolapse during the labor of a woman at 35–36 weeks of pregnancy while using intrauterine device

2020 ◽  
Vol 69 (2) ◽  
pp. 89-92
Author(s):  
Marina N. Mochalova ◽  
Lyubov A. Kuzmina ◽  
Anastasia Yu. Mironenko ◽  
Viktor A. Mudrov
Keyword(s):  
Cesarean Section ◽  
Clinical Case ◽  
Intrauterine Device ◽  
Abdominal Cavity ◽  
Genital Prolapse ◽  
Operative Delivery

A clinical case of operative delivery of a woman with stage 3 genital prolapse, which was diagnosed at 3536 weeks of gestation, is addressed in this article. The woman became pregnant while using intrauterine device. During cesarean section, the patient was diagnosed with complete uterus didelphia. In the abdominal cavity, between the two uteruses, a T-shaped intrauterine device was detected, with no signs of uterus perforation revealed.

scholarly journals A randomized controlled trial of sublingual Misoprostol - 600µg versus intravenous Oxytocin - 10IU in prevention of post partum hemorrhage during cesarean section

2019 ◽  
Vol 8 (10) ◽  
pp. 3865 ◽  
Author(s):  
Rajasri G. Yaliwal ◽  
Shailaja R. Bidri ◽  
Ashwini S. Navani
Keyword(s):  
Blood Loss ◽  
Cesarean Section ◽  
Late Onset ◽  
Post Partum ◽  
Common Side Effect ◽  
Suitable Alternative ◽  
Post Partum Hemorrhage ◽  
Emergency Cesarean ◽  
Estimated Blood Loss ◽  
Sublingual Misoprostol

Background: Mortality related to pregnancy and childbirth causes half a million women around the world to die annually. About 35% of these deaths are from postpartum hemorrhage (PPH). Prevention of PPH has been advised by the WHO by the use of Oxytocin 10 IU IM or IV and Misoprostol 600 µg in low resource settings in vaginal delivery. However there have been only a few reports on the use of Misoprostol during cesarean section. The best route and dose of Misoprostol is still being debated.Methods: One hundred women with term singleton pregnancy undergoing elective or emergency cesarean section under spinal anesthesia were randomly allocated to receive either Misoprostol 600µg sublingually or intravenous oxytocin 10 IU soon after delivery of the baby. Estimated blood loss and comparative change in preoperative hemoglobin to post operative hemoglobin levels and side effects were evaluated.Results: Blood loss was found to be more in Misoprostol than Oxytocin. Eight patients of the Misoprostol group required additional oxytocics. Oxytocin group did not receive any additional drugs. No surgical intervention was made in either of the groups.  The most common side effect with Misoprostol was shivering (46%) and in Oxytocin group fever (4%).Conclusions: Sublingual Misoprostol of 600µg works to prevent postpartum bleeding. In our study Oxytocin was more effective than Misoprostol in preventing PPH during cesarean section. Late onset of action of Misoprostol in comparison to Oxytocin may render suturing of the uterus difficult due to pooling of blood. In settings in which use of Oxytocin is not feasible, Misoprostol might be a suitable alternative for post-partum hemorrhage.

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