INTRODUCTION: Postpartum hemorrhage and intra-operative blood loss during cesarean delivery is a major concern to all obstetrician. Maternal mortality is unacceptably high worldwide. About 830 women die from pregnancy or child -birth related complications around the world everyday. It was estimated that in 2015, roughly 303000 women died during and following pregnancy and child birth. PPH is the leading cause of maternal mortality in low income countries, and the primary cause of nearly one quarter of all maternal deaths globally. AIMS & OBJECTIVE:To measure the efcacy and safety of pre-operative sublingual misoprostol for decrease of blood loss during and after the cesarean sections. MATERIALS AND METHOD: There after subject recruitment was done form July 2018 to June 2019. Effect of sublingual misoprostol prior to cesarean section just before skin incision to decrease bleeding during and after cesarean sections. Patients admitted for delivery in the Gynecology & obstetrics department of SSKM Hospital. RESULT AND ANALYSIS: Our study showed in Control Group, 4(4.3%) patients had needed Blood Trans fusion. Association of Blood Trans fusion needed was statistically signicant (p=0.0431) between two groups. In SUB LINGUAL MISOPROSTOL Group, 7(7.6%) patients had DIARRHOEA, 9(9.8%) patients had NAUSEA,8(8.7%) patients had SHIVERING,8(8.7%) patients had TEMPARATURE RISING and6(6.5%) patients had VOMITING. Association of Adverse effects was statistically signicant (p<0.0001) between two groups. In Control group, SUMMARY AND CONCLUSION: We found that Total blood loss (After delivery of baby and 24 hrs Post- op) was less in sub lingual misoprostol groups compared to control group which was statistically signicant. Hard tone of Uterus during CS was higher in sub lingual misoprostol group in compared to control group which was statistically signicant
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