الفهرس 
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Abstract
Regarding the WHO recommendations for the prevention and treatment of postpartum hemorrhage, the intrinsic contribution of each component of the ‘active management of the third stage of labor’ was examined in light of new available evidence, and relevant recommendations were made. All women giving birth should be offered uterotonics during the third stage of labor for the prevention of PPH; oxytocin (IM/IV, 10 IU) is recommended as the uterotonic drug of choice. Other injectable uterotonics and misoprostol are recommended as alternatives for the prevention of PPH in settings where oxytocin is unavailable.
The misoprostol tablet is very soluble and can be dissolved in 20 minutes when it is put under the tongue a pharmacokinetic study compared the absorption kinetics of oral, vaginal and sublingual routes of administration of misoprostol found that sublingual misoprostol has the shortest time to peak concentration, the highest peak concentration and the greatest bioavailability when compared to other routes.
Aim of the work:
To compare the effectiveness of sublingual misoprostol administered immediately after delivery of the fetus at cesarean section, versus intravenous oxytocin infusion regarding the amount of blood loss.
Methods:
This study was carried out on 245 cases admitted for elective cesarean section at Shatby Maternity University Hospital. They divided into two groups regarding the protocol of treatment, misoprostol group was given 600 mcg misoprostol was administered directly before opening the uterus. And the other group was given oxytocin, 10 IU in 250 ml of Normal saline solution over 10 minutes was administered directly before opening the uterus.
Results:
It was found that the amount of blood loss was higher in Misoprostol group (Mean ± SD: 457.8± 67.23) ml than in oxytocin group (Mean ± SD: 376.7± 64.45) ml, with a Statistically Significant Difference.
The postoperative hemoglobin level was higher in the Oxytocin group (Mean ± SD: 9.68 ± 0.87) g/dl than in Misoprostol group (Mean ± SD: 9.39 ± 0.77), with a Statistically Significant Difference.
In the Misoprostol group there was a DROP of Hemoglobin level 2 g/dl or more in 13 cases while in Oxytocin group 6 cases, with no statistical significance between the 2 studied groups.
The 1 hour postoperative hematocrit level was higher in the Oxytocin group (Mean ± SD: 29.95 ± 2.37) than in Misoprostol group (Mean ± SD: 29.31 ± 2.24), with a Statistically Significant Difference.