Vaginal Misoprostol before Elective Caesarean Section for Preventing Neonatal Respiratory Morbidity

Background: Delivery by elective caesarean section at a gestational age of less than 39 weeks increases the risk of various respiratory morbidities in the newborn including respiratory distress syndrome. Prostaglandins are substances that have beneficial effects on the neonatal lungs as it promote surfactant secretion by inducing the catecholamine surge. However on clinical practice, the effectiveness of the antenatal prophylactic administration prostaglandin is still not clear. Aim: This study aimed to evaluate the efficacy of vaginal Misoprostol before ECS in pregnant women with gestational age less than 38 weeks for preventing the occurrence of neonatal respiratory morbidity. Materials and Methods: Study sample included 159 participants were randomly assigned into 2 groups: Group (A): misoprostol group who administered 1/2 tablet of Cytotec (R) 200 g one hour before elective caesarean section and Group (B): included women received no treatment before elective caesarean section . Results: A significant decrease in respiratory rate among the Misoprostol group and decrease in neonatal respiratory morbidity especially RDS type 2, 3 and TTN, also misoprostol causes significant decrease in the rate of NICU admissions and none of the neonates required mechanical ventilation. Conclusion: Prophylactic misoprostol before elective caesarean at a gestational age of less than 39 weeks reduces the rate of neonatal respiratory morbidity and may prevent neonatal RDS type 2 and 3.