Tranexamic Acid and Ethamsylate For Reducing Blood Loss in Patient Undergoing LSCS at High Risk For Post Partum Hemorrhage: A Randomized Controlled Trial

Abstract

In the current study a double blinded, randomized, controlled trial was carried out on 64 women attending the labor ward in Ain Shams University Maternity hospital to undergo an elective cesarean section or emergency section. 32 of the patients received 1 gm tranexamic acid and 1 gm ethamsylate in addition to oxytocin after delivery of the baby; the other 32 patients received oxytocin only. The patients were monitored for the occurrence of postpartum hemorrhage in the form of intra-operative blood loss, intra-operative or post-operative need for surgical measures to stop bleeding, post-operative vaginal bleeding, also drop in hemoglobin and hematocrit 24 hours postoperative beside the need for blood or parenteral iron transfusion. In the current study, no significant difference between Study and Control groups as regards age (p=0.94), no significant difference between Study and Control groups as regards Gestational age (p=0.88),total blood loss (p<0.001) was significantly lower in study group than control group, Vaginal pads in the 1st 24 hours post-partum was significantly less soaked in study group than control group (p<0.001).no significant difference between Study and Control groups as regards Preoperative Hemoglobin, Postoperative Hemoglobin was significantly higher in study group than control group (p<0.001), Reduction in Hemoglobin was significantly less in study group than control group (p<0.001),no significant difference between Study and Control groups as regards Preoperative Hematocrite, Postoperative Hematocrit was significantly higher in study group than control group (p<0.001), Reduction in Hematocrite was significantly less in study group than control group (p<0.001).Need to iron replacement or blood transfusion was significantly less frequent in study group than control group (p= 0.24).