Efficacy of Oxytocin Infusion VersusTranexamic Acid Infusion in Controlling Blood Loss during Elective Lower Segment Caesarean Section Randomized Clinical Trial

Abstract

his RCT included 138 pregnant women who were elected by inclusion criteria and divided randomly into: group (A) contained 46 women assigned to receive an intravenous slow bolus of oxytocin 10 IU over 1 minute after delivery of baby followed by 40 IU oxytocin in 500 ml of 0.9% saline solution over 4 hours, group (B) contained 46 women assigned to receive an intravenous slow bolus of oxytocin 10 IU over 1 minute and 1 gm tranexamic acid in 200 ml of 0.9% saline solution over 5 minutes after delivery of baby and group (C) contained 46 women assigned to receive only an intravenous slow bolus of oxytocin 10 IU over 1 minute after delivery of baby. It represented a control group. The study showed that oxytocin bolus and infusion (A) is more effective than oxytocin bolus alone (C) in controlling blood loss during elective caesarean section. It is superior as regard to systolic and diastolic blood pressure 1 hour postoperative and heart rate and diastolic blood pressure 4 hour postoperative. Although the blood hemoglobin level seems the same between the two groups, the hematocrite values are higher in case of group (A). Oxytocin bolus and infusion is also superior as regard to estimated blood loss especially the four hours after operation. The calculated blood loss is higher in group (C). The major obstetric hemorrhage (more than 1000 ml) occurred more in group (C) than in group (A). Also there was a decrease in uterotonic agent usage in group (A).