Obstetrical hemorrhage (excessive bleeding related to pregnancy) is a leading cause of
maternal morbidity (disease or symptom of disease) and mortality (death) worldwide with a
significantly higher frequency and severity following cesarean delivery. Twin gestations
(twin pregnancy) are at particularly higher risk for postpartum hemorrhage, yet the
management of obstetrical bleeding following twin delivery remains identical to singleton
delivery.
The purpose of this study is to understand the effect of prophylactic methylergonovine on
blood loss in scheduled twin pregnancy cesarean deliveries. Participants will be randomized
(like tossing a coin) to Methylergonovine (investigational drug) or water with salt (saline)
(placebo). Methylergonovine or saline will be given as an injection immediately after
delivery.