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

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.

Keywords: Blood loss; Cesarean; Melatonin; Spinal anesthesia.

Conflict of interest statement

Conflicts of interestThe authors of this paper declare no conflicts of interest.

© Federation of Obstetric & Gynecological Societies of India 2019.

Figures

Fig. 1

Consort flow diagram

Fig. 2

Comparison of sedation scores in three study groups. Data are presented as percent % of patients. P placebo, M3 melatonin 3 mg, M6 melatonin 6 mg

Fig. 3

Hemodynamic changes in three study groups. Value are presented as mean ± SD, MAP = mean arterial blood pressure (mmHg); HR heart rate (bpm), SA spinal anesthesia. P placebo, M3 melatonin 3 mg, M6 melatonin 6 mg

Fig. 4

Side effects observed in three study groups. Data are presented as number of patients. P placebo, M3 melatonin 3 mg, M6 melatonin 6 mg