Comparison of the Effect of Tranexamic Acid and Misoprostol on Blood Loss During and After Cesarean Section: A Randomized Clinical Trial

Background: One proposed methods to reduce the amount of bleeding during and after cesarean section, is the use of drugs such as Tranexamic acid and Misoprostol.This study aimed to compare the effect of Tranexamicacid and Misoprostol on bloodloss during and after cesarean section. Methods: This is a randomized clinicaltrial performed in Shariati and Khalij-e-Fars Hospitals of Bandar Abbas, Hormozgan, during ۲۰۱۵-۲۰۱۶. The study population included all candidates for cesarean section. ۳۰۰ pregnant women aged ۱۸-۴۰ years with gestational age of ۳۷-۴۲ weeks were included, divided into three groups each: A received tranexamic acid,B, misoprostol, and C, ۲۰۰ cc normal saline. During C/S , all patients received ۲۰ and ۳۰ units of oxytocin, respectively. The level of blood loss during the operation was determined by measuring the total blood volume suctioned after removing the placenta and the difference in the weight of bloody sterile pads and surgical sheets before and after the operation. Results: Preoperative hemoglobin level was ۱۱.۹۶±۱mg/dl in the groupA,۱۱.۶۲±۱.۲۱mg/dl in the groupB, and ۱۲.۲۸±۱.۲۶mg/dl in the placebo group, which was statistically significant (P=۰.۰۰۱). Postoperative hemoglobin level was reduced about ۱.۰۲±۰.۳۵(۱۰.۹ ±۰.۹۹mg/dl) in the groupA, ۱.۱۹±۰.۵۲(۱۰.۴۶±۱.۰۴mg/dl) in the groupB, and ۱.۳۶±۰.۵۰(۱۰.۹۳±۱.۳۴mg/dl) in the placebo group. There was a significant difference between the three groups in the volume of bloodloss during the operation and the first two hours after the operation(P

Keywords:

Postpartum hemorrhage , Cesarean section , Tranexamic acid , Misoprostol