Comparison between 200, 400 and 600 microgram rectal misoprostol before caesarian section to reduce intra and post-operative blood loss / Mastoura Shebl Ali ; Supervised Nermen Abousalem , Hadeer Elsaid Meshal

Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Gynecology and Obstetrics

The achievement of safe childbirth by cesarean section (C.S.) was one of the greatest medical advances of the 20th century. Indeed, C.S. is now the most frequent operation performed in the USA, constituting approximately one third of all the deliveries annually (Ramos, Moore, 2010). Epidemiologic data report a C.S. incidence of 20%{u2013}30% worldwide, with comparable rates in high-income and low-income countries. (Madhukar, 2000) (Khawaja et al., 2009). Nonetheless, the trend toward an increasing reliance on C.S. has several disadvantages, including high rates of secondary infertility owing to postoperative adhesions (Awonuga et al., 2011). In addition, increased rates of abnormal placentation (including previa and accreta), uterine rupture, blood transfusions, and hysterectomy in future pregnancy have been reported (Al-Zirqi et al., 2010) (Marshall et al., 2011). Intra-partum and early postpartum blood loss are also increased in conjunction with C.S. The American Congress of Obstetricians and Gynecologists (ACOG) defines postpartum hemorrhage (PPH) as the loss of more than 500 mL of blood after vaginal delivery and the loss of 1000 mL or more after C.S (ACOG, 2006)

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