{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T20:34:00Z","timestamp":1773866040168,"version":"3.50.1"},"reference-count":22,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2015,10,14]],"date-time":"2015-10-14T00:00:00Z","timestamp":1444780800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2015,10,14]],"date-time":"2015-10-14T00:00:00Z","timestamp":1444780800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2015,9,1]],"date-time":"2015-09-01T00:00:00Z","timestamp":1441065600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["ijgo.org","clinicalkey.jp","clinicalkey.com","clinicalkey.es","clinicalkey.com.au","clinicalkey.fr","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2016,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To determine the optimum time for misoprostol administration to minimize blood loss during and after elective cesarean delivery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A randomized clinical trial was conducted at Mansoura University Hospital, Egypt, between January 1, 2013, and December 31, 2014. Eligible participants had full\u2010term pregnancies, were scheduled to have a cesarean, and had normal fetal heart tracing. Patients were randomly allocated into two equal groups using computer\u2010generated tables and sealed opaque envelopes. Misoprostol (400 \u03bcg, given rectally) was given either before (group 1) or after (group 2) surgery. Patients, investigators, and data analysts were not masked to group assignment. The primary outcome was blood loss.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 348 women were included (174 in each group). Blood loss was significantly lower in group 1 than in group 2 (570 \u00b1 240 vs 844 \u00b1 270 mL; <jats:italic>P<\/jats:italic> &lt; 0.001). The frequency of maternal and neonatal adverse events did not differ between the groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Preoperative misoprostol (400 \u03bcg, given rectally) reduces blood loss to a greater extent than does postoperative misoprostol during elective cesarean delivery. The frequency of complications was not affected by time of administration.<\/jats:p><\/jats:sec>","DOI":"10.1016\/j.ijgo.2015.06.057","type":"journal-article","created":{"date-parts":[[2015,10,22]],"date-time":"2015-10-22T22:21:18Z","timestamp":1445552478000},"page":"82-84","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":9,"title":["A randomized clinical trial of preoperative versus postoperative misoprostol in elective cesarean delivery"],"prefix":"10.1002","volume":"132","author":[{"given":"Ahmed","family":"Ragab","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rafik","family":"Barakat","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed A.","family":"Alsammani","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,10,14]]},"reference":[{"key":"e_1_2_6_2_2","first-page":"CD004453","article-title":"Abdominal surgical incisions for caesarean section","volume":"5","author":"Mathai M.","year":"2013","journal-title":"Cochrane Database Syst Rev"},{"issue":"4","key":"e_1_2_6_3_2","first-page":"1039","article-title":"ACOG practice bulletin: clinical management guidelines for obstetrician\u2010gynecologists number 76, October 2006: postpartum hemorrhage","volume":"108","author":"American College of Obstetricians and Gynecologists","year":"2006","journal-title":"Obstet Gynecol"},{"issue":"1","key":"e_1_2_6_4_2","first-page":"CD003249","article-title":"Treatment for primary postpartum haemorrhage","author":"Mousa H.A.","year":"2007","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/00001703-200404000-00008"},{"issue":"3","key":"e_1_2_6_6_2","first-page":"159","article-title":"Uses of misoprostol in obstetrics and gynecology","volume":"2","author":"Allen R.","year":"2009","journal-title":"Rev Obstet Gynecol"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200101043440107"},{"key":"e_1_2_6_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(06)69522-6"},{"issue":"2","key":"e_1_2_6_9_2","first-page":"469","article-title":"Efficacy of rectal misoprostol for prevention of postpartum hemorrhage","volume":"12","author":"Mirteimouri M.","year":"2013","journal-title":"Iran J Pharm Res"},{"key":"e_1_2_6_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2006.05.031"},{"key":"e_1_2_6_11_2","unstructured":"DeanA.G. 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