Role of Uterotonics in Reducing Intraoperative Blood Loss in Patients With PASD Undergoing Cesarean Hysterectomy

Inclusion Criteria: * Pregnancy of singleton living fetus * Previous one or more cesarean sections * Gestational age: \> 32 weeks * The following ultrasound markers such as "loss of clear retroplacental translucency", "myometrial thinning", "abnormal lacunae", "irregular bladder wall", "utero-vesicalhypervascularity". * Preoperative hemoglobin more than 10 gm/dl * Cases with PAS that will undergoing CS Hysterectomy Exclusion Criteria: * Maternal medical disorders e.g.: coagulation defects, cardiac diseases etc.…. * Any known or reported hypersensitivity to the used medication. * All cases with spontaneous placental separation at laparotomy. * All patients undergoing conservative management of PAS. * All cases which necessitate emergency termination.