* Misoprostol reduces the uterine bleeding after cesarean delivery without harmful effects on either mother or baby. * The aim of the this study is to address if there is any benefits 'regarding the intra-operative blood loss' from preoperative rectal administration of 400 mic of Misoprostol in addition to the routinely administrated 10 units of oxytocin
Research question: In women undergoing elective ceserean section, is preoperative 400 mic Misoprostol reduce intra-operative blood loss? Research hypothesis: pre-operative Misoprostol doesn't reduce intraoperative blood loss in women undergoing ceserean section
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
QUADRUPLE
Enrollment
280
400 microgram of misoprostol is given preoperatively in patients undergoing elective cesarean section
women will recive 2 identical tablets as placeboo
Faculty of Medicine, Ain Shams University
Cairo, Cairo Governorate, Egypt
volume of intraoperative blood loss
volume of intraoperative blood loss will be measured in "cc" by a didcated nurse who will use separate suction sets to differentiate between blood and liquor
Time frame: 30 minute
maternal mortality
Time frame: 6 months
mean measured blood loss
Time frame: 1, 2, and 24 h postpartum
placental retention
when the placenta is not delivered spontaneously for 30 minutes
Time frame: 30 minutes
requirement for blood transfusion
indicated per clinical protocol at the study site for mothers with a hemoglobin \<100 g/l and/or severe pallor
Time frame: 24 hours
requirement for additional management of PPH, including therapeutic uterotonic drugs or surgical or radiological procedures
Time frame: 24 hours
postpartum hemoglobin
less than 10gm%
Time frame: 24 hours
mean postpartum hematocrit
more than 10% drop in the postpartum hematocrit
Time frame: 24 hours
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