Standard Oxytocin Versus High Dose Oxytocin to Control Postpartum Hemorrhage in High Risk Pregnancy During Elective Cesarean Section

Standard Oxytocin Versus High Dose Oxytocin to Control Postpartum Hemorrhage in High Risk Pregnancy During Elective Cesarean Section

Controlling hemorrhage during and after a cesarean section reduces significantly maternal mortality and morbidity and the present study is important for detection of the effectiveness of routinely increasing the oxytocin dose instead of using the standard dose only in preventing postpartum hemorrhage and additional use of uterotonics in the first 24 hours after cesarean section for high risk pregnancy.

Inclusion Criteria:

• - Medical disorders ie: Hypertensive diseases with pregnancy - Diabetes Mellitus - Collagen diseases - Coagulopathies - Cardiac diseases - Anemia
• History of postpartum hemorrhage
• Placental disorders ie: placenta previa
• Infertility and ICSI
• High Parity
• History of Endometriosis
• Fetal disorders (IUGR, IUFD, Preterm, Congenital anomalies, oligohydramnios or polyhydramnios, macrosomia)
• Preterm labor on uterine relaxants
• Twins pregnancy
• Patients on antiplatelets and anticoagulants
• Uneventful antenatal care

Exclusion Criteria:

• - Oxytocin Allergy
• Normal uncomplicated pregnancy
• Emergency cesarean section
• Exhausted uterus due to trial of normal labor
• Couvelaire uterus