Neonatal respiratory distress may occur in either term or preterm newborns with a higher relative risk in preterm, and whether born vaginally or through caesarean section, but in a higher percentage after elective caesarean section whose rate is rising.

Prostaglandins may be given about one hour before an elective caesarean section after excluding the presence of contraindication to their use to decrease the neonatal respiratory diseases and thus, the number of children who suffered from bronchopulmonary dysplasia that occurs frequently in children who had previously TTN will diminish.

Inclusion Criteria:

• Age: 18 years or more.
• Term singleton pregnancy (38 - 38+6 weeks gestation).
• Planned for elective transverse lower segment caesarean section with an indication.

Exclusion Criteria:

• Women with history of significant cardiac disease, eclampsia, pre eclampsia, epilepsy, severe asthma, severe allergic condition, vascular disease, renal or hepatic disease.
• Women with contraindication to prostaglandins as Glucoma or known hypersensitivity to prostaglandins or specifically for misoprostol.
• Psychological problem or mental disease that renders the patient not able to understand the nature, scope, and sequences of the study.
• Pregnancies with known foetal malformation/s or chromosomal aberration.