Authors: Uchenna Nelson Nwaedu, Odidika Ugochukwu Joannes Umeora, Matthew Igwe Nwali, Joshua Adeniyi Adebayo, Cosmas Ayadiuno Nnonyelu, Upo Emeri Mba, Joseph Agboeze, John Okafor EGEDE, Nnenna Assumpta Nweke.
Purpose: Oxytocin is used to prevent hemorrhage due to uterine atony but postpartum hemorrhage is still a problem. Melatonin was suggested as an adjunct to oxytocin in blood loss reduction during cesarean. This study determines the effectiveness of Melatonin with oxytocin versus Oxytocin alone in reducing blood loss at cesarean section.
Methods: A double blinded randomized controlled trial for cesarean section. One arm received 10mg of sublingual melatonin while the other arm received placebo (100mg of Vitamin C) after spinal Anesthesia. 10IU of intravenous Oxytocin was given to both arms after the delivery of the baby. The concept of intention to treat was used for protocol deviations during the study period.
Results: Sociodemographic, indication and type of surgery were fairly distributed in the two arms. There was no significant difference in preoperative hemoglobin and platelet count. Blood loss was lower in melatonin arm (P < 0.001) and postoperative hemoglobin (P = 0.003). The placebo arm higher difference between preoperative and postoperative hemoglobin (P < 0.001) and received higher blood transfusion (P = 0.049). Side effects and neonatal outcome were same.
Conclusion: Melatonin with oxytocin reduces blood loss during cesarean section more than oxytocin alone with minimal fetal and maternal side effects and should be encouraged.
Contribution: Combination of sublingual melatonin and oxytocin reduces hemorrhage, blood transfusion and maternal mortality after cesarean section.
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