* Corresponding author: Jila Agah, Assistant Professor, Department of Obstetrics and Gynecology, Faculty of medicine, Sabzevar University of Medical Sciences, Sabzevar, Iran. Tel: 00989153012952; Email: jilaagah@yahoo.com Prevention of Post-cesarean Nausea and vomiting by Intramuscular Metoclopramide: A Randomized Clinical trial Jila Agah (MD) 1* , Roya Baghany (MSc) 2 , Seyed Mohammad Mireskandari (MD) 3 , Mohammad Hassan Rakhshani (PhD) 4 1 Assistant Professor, Department of Obstetrics and Gynecology, Faculty of medicine, Sabzevar University of Medical Sciences, Sabzevar, Iran 2 MSc in midwifery, Faculty of Nursing and Midwifery, Sabzevar University of Medical Sciences, Sabzevar, Iran 3 Associate professor in Anesthesiology, Department of Anesthesia and Intensive Care, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran 4 MSc in Biostatics, Department of Biostatistics, Faculty of Health, Sabzevar University of Medical Sciences, Sabzevar, Iran A R T I C L E I N F O A B S T R A C T Article type: Original article Background & aim: Nausea and vomiting are considered as the main post- cesarean complications in women undergoing cesarean section. Therefore, the present study aimed to examine the efficacy of intramuscular metoclopramide before cesarean section to prevent post-cesarean nausea and vomiting. Methods: Study population in the present study consisted of 617 women scheduled for cesarean section. The participants were randomly divided into intervention and control groups. The intervention group received 10 mg intramuscular metoclopramide prior to the surgery, compared to the control group taking an aquatic neutral placebo. Nausea, vomiting, feeling of hunger, and eating time were assessed postoperatively using a visual analog scale every 4 hour. Data were analyzed using the Chi-square test and t-test in SPSS software (version 17). Results: During 12-hour postoperative observation, the incidence and intensity of nausea were lower in the metoclopramide group (P=0.005). Metoclopramide group clearly needed a less severe therapeutic approach for nausea (14% vs. 44%). Furthermore, participants in the intervention group showed a decline in vomiting; however, this decline was not significant (P=0.4). The metoclopramide group developed the feeling of hunger and eating sooner than those in the control group (P=0.003, P=0.002, respectively). None of the participants reported any side effects of this medication. Conclusion: The intramuscular injection of 10 mg metoclopramide before cesarean section decreased the incidence and intensity of nausea as well as discharge time from the hospital. Metoclopramide is recommended as a safe, available, and inexpensive medication, which can result in a higher level of maternal health and shorter period of hospitalization. Article History: Received: 01-Mar-2018 Accepted: 07-Oct-2018 Key words: Cesarean Intramuscular Metoclopramide Nausea Prevention Please cite this paper as: Agah J, Baghany R, Mireskandari S M, Rakhshani M H. Prevention of Post-cesarean Nausea and vomiting by Intramuscular Metoclopramide: A Randomized Clinical trial. Journal of Midwifery and Reproductive Health. 2019; 7(3): 1846-1851. DOI: 10.22038/jmrh.2019.30231.1328 Introduction Nausea and vomiting are common distressing symptoms experienced commonly after surgeries, particularly abdominal surgeries. The incidence of postoperative nausea and vomiting (PONV) has not been fully known. However, the overall incidence rate of PONV has been reported as 20- 30%, but increasing up to 80% in high-risk circumstances [1, 2]. The PONV can be more significant following cesarean, compared to other operations since the factors of age and gender heighten the risk of PONV. In addition, a reduction in gastrointestinal peristalsis leads to physiologic changes during pregnancy, which enhance the susceptibility to PONV [3, 4]. Other factors that can contribute to the PONV include hypoxia, hypotension, anesthetic regimen, use of nitrous oxide for analgesia, postoperative use of opiates, psychological factors, and the exteriorization of the uterus during cesarean.