Misoprostol+Oxytocin vs. Carbetocin in CS

Adjuvant Use of Misoprostol and Oxytocin vs. Carbetocin for the Prevention of Post-partum Hemorrhage in Elective Cesarian Section

This prospective randomized double-blind clinical trial will be conducted at Ain-Shams University Maternity Hospital, Cairo, Egypt. Patients eligible for elective lower segment cesarean section will be randomized to 2 groups. Group 1: will receive 400 ug misoprostol following + 10 IU oxytocin intravenous slowly after cord clamping. Group 2: will receive 100 ug carbetocin intravenous after cord clamping.

Inclusion Criteria:

• Women with singleton pregnancy Women scheduled for elective CS full term (gestational age ≥37 weeks).

Exclusion Criteria:

• hypersensitivity to oxytocin, carbetocin or prostaglandins
• contraindication to prostaglandins (e.g. glaucoma)
• history of significant heart disease
• severe asthma
• epilepsy
• history or evidence of liver
• renal or vascular disease
• history of coagulopathy
• thrombocytopenia or anticoagulant therapy
• women with HELLP syndrome
• eclampsia
• women presenting by placental abruption
• contraindication to spinal anesthesia as carbetocin is licensed for use with regional anesthesia only.