Preoperative vs. Postoperative Misoprostol in Elective Cesarean Section

Preoperative vs. Postoperative Misoprostol in Elective Cesarean Section: A Double-blind Randomized Clinical Trial

This prospective double-blind placebo-controlled randomized clinical trial will be conducted at Ain-Shams University Maternity Hospital from April 2017 till October 2017. 120 women candidate foe elective cesarean section will receive preoperative sublingual 400 microgram of misoprostol, and another 120 women will receive postoperative sublingual 400 microgram of misoprostol.

Inclusion Criteria:

• Patients booked for elective cesarean section.
• Singleton pregnancies.
• Full term pregnancies (GA 37- 42 Wks).
• Age (18-40 yrs).
• body mass index (BMI) (20-30(Kg/m2 .

Exclusion Criteria:

• Contraindication to spinal anesthesia.
• Blood dyscrasias.
• Large fibroids.
• Multiple pregnancies.
• Overdistended uterus eg. Hydramnios.
• Pre-eclampsia.
• Marked maternal anemia (Preoperative hemoglobin < 9 gm/dl).
• Previous history of PPH.
• Contraindications to prostaglandin therapy (e.g. history of severe bronchial asthma or allergy to misoprostol.
• Placenta previa.
• Previous myomectomy.
• Extreme of BMI (<20 or >30 Kg/m2 ).