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Effect of Melatonin on Blood Loss After Cesarean Section: A Prospective Randomized Double-Blind Trial

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Abstract

Background and Objectives

The similarities between the melatonin and oxytocin signaling could lead to increased contractility of myometrium. We designed this randomized double-blind, placebo-controlled trial to evaluate the efficacy of melatonin in reduction of blood loss during and after the lower segment cesarean section.

Methods

One hundred and twenty patients who had been scheduled for cesarean section under spinal anesthesia were enrolled in the study. We randomly allocated them to one of the three following groups to receive either melatonin 3 mg (M3), melatonin 6 mg (M6), or placebo (P) sublingually 20 min before the surgery. The hemoglobin levels before and 12 h after surgery, the mean weight of the materials used in the operation time, the need for additional oxytocic therapy, and the incidence of adverse effects were probed and recorded.

Results

There was a significant difference between the group M6 and both M3 and P in the mean weight of the materials (p = .024 and .041, respectively) and between M6 and P groups in terms of mean decrease in hemoglobin during 12 h after cesarean section (p = .029).

Conclusion

Using 6 mg melatonin, sublingually, as a premedication in patients undergoing cesarean section with spinal anesthesia could statistically reduce the amount of blood loss after the lower segment cesarean section, although it may not be clinically meaningful.

Registration number: ACTRN12612000117819 and ClinicalTrials.gov Identifier: NCT01572805

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Acknowledgments

This work was partially supported by the Vice Chancellor of Research of Qazvin University of Medical Sciences. The results described in this study are part of the thesis of Dr. Morteza Delkhosh Reihany. The authors would also like to especially thank the Kosar Hospital Research Center.

Funding

There is no conflict of interest between the authors themselves, the Research Department of Qazvin University of Medical Sciences as the sole financial supporting body, or any pharmaceutical company regarding the materials used in our study.

Author information

Authors and Affiliations

  1. Department of Anesthesiology, Faculty of Medicine, Qazvin University of Medical Science, Qazvin, Iran

    Marzieh Beigom Khezri MD & Morteza Delkhosh Reihany MD

  2. Dpartment of Obstetrics and Gynecology, Faculty of Medicine, Qazvin University of Medical Sciences, Qazvin, Iran

    Talaat Dabbaghi Ghaleh MD

  3. Department of Community and Preventive Medicine, Faculty of Medicine, Qazvin University of Medical Sciences, PO Box 3419759811, Qazvin, Iran

    Navid Mohammadi MD, MPH

  4. Preventive Medicine and Public Health Research Center, Iran University of Medical Sciences, Tehran, Iran

    Navid Mohammadi MD, MPH

Authors
  1. Marzieh Beigom Khezri MD
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  2. Morteza Delkhosh Reihany MD
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  3. Talaat Dabbaghi Ghaleh MD
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  4. Navid Mohammadi MD, MPH
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Corresponding author

Correspondence to Navid Mohammadi MD, MPH.

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The authors of this paper declare no conflicts of interest.

Ethical Approval

We acknowledge that our work as clinical research was performed according to the ethical standards of the institution and national Iranian codes of research ethics as well as 1964 Helsinki declaration and its later amendments.

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Marzieh Beigom Khezri is working as associate professor of anesthesia in a tertiary teaching hospital, specialized for obstetrics and gynecology affiliated to Qazvin University of medical science. Her areas of interest in research are mostly in the fields of post-operative pain and obstetric hemorrhage management; Morteza Delkhosh Reihany has worked as an anesthesiologist since 2013. He completed his fellowship in palliative medicine last year. Furthermore, he works as an anesthesiologist and also in pain clinic for relieving chronic pains now. Dr. Delkhosh is interested in clinical research in the field of pain and advanced methods of anesthesia; Talaat Dabbaghi Ghaleh is an expert gynecologist with 24 years of educational and academic experience. She has also completed a fellowship in infertility and works in an infertility clinic too. Dr. Dabbaghi is a faculty in Qazvin University of Medical Sciences with the rank of the associate professor now; Navid Mohammadi is a practiced physician and associate professor in community and preventive medicine at Qazvin University of Medical Sciences, Iran. Dr. Mohammadi is also a director member of the preventive medicine and public health research center in Iran University of Medical Sciences, Tehran, Iran. He has completed fellowship in “simulation in medical education” from the University of Ottawa, Canada in 2015. Dr. Mohammadi is interested in clinical and epidemiological research to improve patient care as well as the level of knowledge about health problems in the community.

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Khezri, M.B., Reihany, M.D., Dabbaghi Ghaleh, T. et al. Effect of Melatonin on Blood Loss After Cesarean Section: A Prospective Randomized Double-Blind Trial. J Obstet Gynecol India 69, 436–443 (2019). https://doi.org/10.1007/s13224-019-01205-7

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  • DOI: https://doi.org/10.1007/s13224-019-01205-7

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