Efficacy Intravenous Tranexamic Acid in Reducing Blood Loss after Elective Cesarean Sections

Abstract
Background: Delivery by CS can cause more complica-tions than normal vaginal delivery and one of the most common complications is primary or secondary postpartum haemor-rhage. The coagulation and fibrinolytic systems are believed to be in a state of dynamic balance that maintains an intact vascular system. Tranexamic acid (TXA) is a potent anti fibrinolytic agent that exerts its effects by blocking lysine binding sites on plasminogen molecules and has the potential to enhance the effectiveness of the patient's own haemostatic mechanisms.
Aim of Study: To study the efficacy and safety of tran-examic acid in reducing blood loss during and after the lower segment cesarean section.
Methods: This Prospective Comparative study was held on one hundred and fifty patients from Obstetrics and Gynae-cology Department of El-Sayed Galal University Hospital (Al-Azhar University) and El-Sahel Teaching Hospital.
•Group A (TA group): 50 patients would had 1g/10mL TA diluted with 20mL of 5% glucose.
•Group B (Misoprostol group): 50 patients would had 5 rectal 200 micrograms Misoprostol pills (misotac) were used.
•Group C (Oxytocin group): 50 patients would had 20IU oxytocin in 500mL lactated Ringer's solution will be infused at a rate of 125mL/h.
Results: No statically differences between groups as regarding demographic characteristics of the patients.No statistically significant difference between groups according to indication of CS. No statistically significant difference between groups according to vital signs before treatment. Statistically significant difference between groups according to vital signs immediately after placental delivery and 1hr after CS for oxytocin group. No statistically significant difference between groups according to vital signs (2hr after CS). No statistically significant difference between groups according to laboratory data before delivery. No statistically significant difference between groups according to Total blood loss. No statistically significant difference between groups according to laboratory data on (2nd day). No statistically significant difference between groups according to neonatal manifestations.
Conclusion: The use of tranexamic acid prior to caesarean section may have the effectiveness to reduce and minimize blood loss with no major side effects recorded throughout the study either for the mother nor for the babyagainst postpartum hemorrhage as shown by the results of this study.