IMR Press / CEOG / Volume 47 / Issue 6 / DOI: 10.31083/j.ceog.2020.06.5530
Open Access Original Research
Rectal misoprostol after cesarean delivery: does it affect recovery of bowel functions? A prospective randomized trial
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1 Associate professor of Obstetrics and Gynecology, Faculty of Medicine, Taif University, Kingdom of Saudi Arabia
*Correspondence:; (NISREEN KHALED AREF)
Clin. Exp. Obstet. Gynecol. 2020, 47(6), 906–910;
Submitted: 7 March 2020 | Accepted: 15 May 2020 | Published: 15 December 2020
Copyright: © 2020 Aref Published by IMR Press
This is an open access article under the CC BY 4.0 license

Aim: To assess the efficacy of rectally administered misoprostol in the improvement of bowel function recovery after cesarean delivery (CD). Methods: This prospective randomized trial was conducted among 171 pregnant women subjected to term elective CD. Patients were divided equally into 3 groups by simple randomization. Participants in group A were given misoprostol 200 μg rectally; those in group B were given misoprostol 400 μg rectally just after CD but before leaving the operating theater, while the participants in group C did not receive any rectal drug. The study outcome measures were: duration before first bowel movement and start of the regular oral diet. Adverse effects, need for additional analgesics, and post-CD hospital stay period were also recorded. Results: The mean times to first audible intestinal sounds and to the first passage of flatus were significantly lower in group B (14.1 ± 1.4 h and 16.7 ± 2.3 h, respectively) when compared to both groups A and C [ 21.9 ± 5.3 h and 24.9 ± 5.7 h (A) vs. 23.6 ± 6.9 h and 27.1 ± 7.9 h (C)] (p = 0.001). It was found that notably, patients in group B resumed diet more quickly, with a mean period of 20.5 h, which was significantly faster than the remaining groups (29.8 h and 33.1 h in groups A and C, respectively Of great interest, patients in group B had a lower post-CD hospital stay (38.5 h vs. 59.2 h in group A and 64. 8 h in group C). Conclusion: For the recovery of bowel functions after CD, rectal administration of 400 μg misoprostol appears to be more effective than 200 μg of rectally administrated misoprostol or traditional feeding regimens.

Bowel motility
Cesarean section
Post-CS recovery
Figure 1.
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