The aim of this study is to assess the efficacy of IM neostigmine (0.5 mg) for acceleration of bladder evacuation and prevention of postoperative urine retention following cesarean delivery carried out under spinal anesthesia

Following cesarean delivery, women will receive either 0.5 mg IM neostigmine (study group) or IM NaCl 0.9% (control group). Bladder ultrasonography will be done every hour until spontaneous voiding occurs. If postoperative urine retention occurred (void inability with bladder volume > 600 ml by ultrasound), urinary catheterization will be done.

Inclusion Criteria:

• Pregnant women undergoing elective cesarean deliver under spinal anesthesia.

Exclusion Criteria:

• The age of the patient is more than 35 years of less than 20 years.
• The body mass index of the patient is more than 35 kg/m2 or her height is more than 180 cm or less than 150 cm.
• Multiple gestation.
• The patient is in active labor.
• Vaginal bleeding, placenta previa or abruption of the placenta.
• Presence of fetal distress.
• Urinary symptoms.
• Medical disorders co-existing with or complicating pregnancy.
• Contraindications for or history of adverse reaction of Neostigmine.
• Contraindication for spinal anesthesia.
• Refusal of the patient to receive spinal anesthesia.
• Intraoperative significant hemorrhage.
• Duration of the operation is more than one hour.
• Occurrence of postoperative complications as eclampsia.

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