Rectal misoprostol versus tranexamic acid in reducing intra &post operative blood loss in cesarean section

Document Type : Original Article

Authors

1 Obstetrics and Gynecology department, Faculty of Medicine, Beni-Suef University, Egypt

2 Obstetrics and Gynecology department, Faculty of Medicine, Beni-suef University, Egypt

Abstract

Objective: To evaluate the effects of intravenous tranexamic acid (TA) and rectal misoprostol on reducing blood loss intra and post operative in caesarean section among low risk and high risk groups. Methods:200 pregnant women attending for elective cesarean delivery in Beni-Suef University hospital  were randomly allocated to two groups  First group is  high risk group  ,second group is low risk group  ,then each group is subdivided into 2groups one of them is misoprostol group(received 400 microgram rectal misoprostol) and the other is tranexamic acid group(received1 gm (10 ml) (2amp) Tranexamic acid).In all groups, Following the delivery of the baby, All patients additionally received an intravenous bolus of 10 IU oxytocin (Syntocinon)&additional ecbolics (inform of10IUoxytocin& IM ergometrin) only if blood loss exceeded 500ml or on demand of the operating surgeon.At the end of the operation, the amount of bleeding was assessed and Post partum blood loss during the first 24hours after surgery was  assessed by weighing pads. Results&conclusion: the rectal misoprostol or intravenous Tranexamic acid are equally effective in the reduction of blood loss during and after cesarean delivery in patients with low risk or those with high risk for PPH. Furthermore, there was no statistically significant difference among the studied groups as regard the occurrence of postpartum hemorrhage (> 1000ml in the first 24 hours)   and the Apgar score of the neonate at 1 minute and at 5 min. No misoprostol or tranexamic acid side effects had been reported.

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References

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