Abstract No.: ABS2482: A comparative study to evaluate the effect of melatonin on blood loss after elective Caesarean section: a randomised double blind study.

Abstract

Background & Aims:Postpartum hemorrhage (PPH) being a cause for one-third of obstetric deaths, its prevention helps decreasing blood loss at caesarean section. Melatonin acts on MT1 and MT2 receptors in the myometrium, and similarities between melatonin and oxytocin signaling could lead to increased contractility.Severe pre-eclampsia (n=19)Mild pre-eclampsia (n=16)Healthy controls (n=35) P Mean ONSD (mm) Mean±SD5.36±0.324.71±0.354.24±0.38<0.0001, S vs M: <0.0001, S vs H: <0.0001, M vs H: <0.0001LUSS score Median (IQR)11 (4.5-16)1 (0-4.25)0 (0-1.5)<0.0001, S vs M: 0.0008, S vs H: <.0001, M vs H: 0.107Methods:After obtaining informed-written-consent, patients were randomly allocated to 2 groups, of 30 each to receive either melatonin 3mg (group M3), or placebo (group P) orally, 1h before spinal-anaesthesia. Patient was preloaded with 10ml/kg ringer-lactate solution. In operating-room, standard monitoring was connected. Oxygen was delivered at 4L/min. SAB was administered, and motor-blockade determined using modified-Bromage-scale. After delivery, injection oxytocin was given. Haemoglobin values were determined before and 12h after surgery. Blood-loss (ml) was measured-as a) the difference between the weight of used materials before and after the surgery and b) the volume of suction after placental delivery. The sedation score assessment was done. Neonatal Apgar score and birth weight were noted.Results:There was significant difference between group M and group P in total blood loss with mean 1357.17 and 1440 and standard deviation 162.82 and 170.31 respectively with p=0.029539.Conclusion:The use of melatonin 3mg orally as premedication in pregnant patients undergoing cesarean section under spinal anaesthesia could statistically decrease the amount of blood loss after caesarean section.Group MGroup P P MeanSDMean SDTotal blood loss1357.17162.821440170.310.029539Pre Op Hb11.260.8711.820.920.1633Post Op Hb10.250.8411.490.890.084116Difference of Hb1.0060.410.920.420.029539