The Effect of Preoperative and Post Operative Misoprostol Administration on Intraoperative Blood Loss and Postpartum Hemorrhage in CS

Study Overview
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Brief Summary
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• Patients will be divided into two groups 100 patients will receive routine ecbolics (for example oxytocin) after delivery of baby The 100 patients will receive routine ecbolics (for example oxytocin) after delivery of baby plus 400 microgram misoprostol rectally with catheterization and another 400 microgram rectally after closure of abdomen Then we will compare between two groups regarding Intaoperative blood loss Risk of Postpartum hemorraghe in the first 24 hrs HB pre and postoperative for all patients Intraoperative blood loss will be estimated by the number and weight of soaked towels and amount of blood in suction unit

Detailed Description
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• Patients will be divided into two groups 100 patients will receive routine ecbolics (for example oxytocin) after delivery of baby The 100 patients will receive routine ecbolics (for example oxytocin) after delivery of baby plus 400 microgram misoprostol rectally with catheterization and another 400 microgram rectally after closure of abdomen Then we will compare between two groups regarding Intaoperative blood loss Risk of Postpartum hemorraghe in the first 24 hrs HB pre and postoperative for all patients Intraoperative blood loss will be estimated by the number and weight of soaked towels and amount of blood in suction unit

Official Title
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The Effect of Preoperative and Post Operative Misoprostol Administration on Intraoperative Blood Loss and Postpartum Hemorrhage in CS

Conditions
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Post Partum Hemorrhage

Intervention / Treatment
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* Procedure: cesarean section
* Drug: Misoprostol
* Drug: Oxytocin


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: women attending for elective CS. Age between 20-35 years. Normal placental site Normal coagulation profile Full term pregnancies(above 37 wks) Medically free Spinal anesthesia Living baby Average liquor by U/S Exclusion Criteria: • Women attending for emergency CS .age below 20 or above 35 Abnormal placentation (Placenta previa,accrete,increta or percreta) Women with coagulopathy Preterm pregnancies (before 37 wks) Medical disorder (Hypertension,Diabetes, Endocrinal disorder) General anathesia IUFD Oligo or polyhydraminos by U/S

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 35 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Routine ecbolic group<br>100 patients will receive routine ecbolics ( oxytocin) after delivery of baby | Procedure: cesarean section<br>* CS will be done by pfannenstiel incision , transverse lower uterine segment incision ,immediate cord clamping after delivery of baby , closure of uterus by 2 layers , closure of abdomen in layers<br>Drug: Oxytocin<br>* 10 IU of oxytocin with fetal delivery<br>|
| Active Comparator: Misoprostol group<br>The 100 patients will receive routine ecbolics (oxytocin) after delivery of baby plus 400 microgram misoprostol rectally with catheterization and another 400 microgram rectally after closure of abdomen | Procedure: cesarean section<br>* CS will be done by pfannenstiel incision , transverse lower uterine segment incision ,immediate cord clamping after delivery of baby , closure of uterus by 2 layers , closure of abdomen in layers<br>Drug: Misoprostol<br>* The 100 patients will receive routine ecbolics (for example oxytocin) after delivery of baby plus 400 microgram misoprostol rectally with catheterization and another 400 microgram rectally after closure of abdomen<br>* Other names: Cytotec;Drug: Oxytocin<br>* 10 IU of oxytocin with fetal delivery<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| postpartum hemorrhage |  | 24 hours after cesarean section |