Preoperative Rectal Misoprostol in Reducing Blood Loss during a Total Abdominal Hysterectomy: A Randomized Double-Blinded Controlled Trial Study


  • Manasicha Pongsamakthai Department of Obstetrics and gynecology, Khon Kaen Hospital
  • Worasuda Boonsith Department of Obstetrics and Gynecology, Khon Kaen Hospital


Rectal misoprostol, Operative blood loss, Total abdominal hysterectomy


Background and Objective: To compare the blood loss during a total abdominal hysterectomy of the benign uterine disease with preoperative rectal misoprostol administration and a placebo.

Material and Methods: One hundred–twenty patients over 18 years of age, who diagnosed of the benign uterine disease and underwent a total abdominal hysterectomy with or without adnexal surgery, were included from November 2019 to June 2021. The participants were randomized and allocated to undergo either the preoperative administration of the 400 micrograms rectal misoprostol (58 patients) or the placebo (57 patients). This randomized controlled trial recorded the intra-operative blood loss, blood transfusion requirement, operative time, hospital stay, and incidence of all side effects.

Results: The median (IQR) intra-operative blood loss was 162.0 (50.5-308.0) ml for the misoprostol group and 160.0 (50.0-309.0) ml for the placebo group was not statistically significant difference (p = 0.910). The misoprostol group demonstrated lower blood transfusion requirements, operative times, hospital stay, and incidence of side effects than those of the placebo group; but there were no statistically significant differences.

Conclusion: Pre-operative rectal misoprostol administration cannot reduce operative blood loss during a total abdominal hysterectomy.


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How to Cite

Pongsamakthai M, Boonsith W. Preoperative Rectal Misoprostol in Reducing Blood Loss during a Total Abdominal Hysterectomy: A Randomized Double-Blinded Controlled Trial Study. SRIMEDJ [Internet]. 2022 Aug. 30 [cited 2024 Apr. 18];37(4):361-6. Available from:



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