Sublingual Misoprostol to Reduce Blood loss during elective cesarean delivery: A randomised controlled trial

Abstract

Cesarean section is one of the most commonly performed obstetrical operations all over the world. Epidemiologic data report a C.S. incidence of 20% - 30% worldwide, with comparable rates in high income and low income countries. According to the most recent estimates, the average global rate of CS is 18.6%, ranging from 6.0% to 27.2% in the least and more developed regions, respectively .Countries with the highest CS rates in each region are Brazil (55.6%) and Dominican Republic (56.4%) in Latin America and the Caribbean, Egypt (51.8%) in Africa, Iran and Turkey in Asia (47.9% and 47.5%, respectively), Italy (38.1%) in Europe, United States (32.8%) in Northern America, and New Zealand (33.4%) in Oceania. Postpartum hemorrhage (PPH) is a leading cause of maternal mortality and morbidity, especially in low- resource countries. It is responsible for around 30% of maternal deaths world wide and 12% of survivors will have severe anemia.PPH is defined as blood loss of more than 500 mL following vaginal delivery or more than 1000 mL following cesarean delivery, a loss of these amounts within 24 hours of delivery is termed early or primary PPH, whereas such losses are termed late or secondary PPH if they occur 24 hours after delivery.