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12.10.2018 | Original Article | Ausgabe 3/2019

The Journal of Obstetrics and Gynecology of India 3/2019

Comparison of the Effect of Intravenous Tranexamic Acid and Sublingual Misoprostol on Reducing Bleeding After Cesarean Section: A Double-Blind Randomized Clinical Trial

Zeitschrift:
The Journal of Obstetrics and Gynecology of India > Ausgabe 3/2019
Autoren:
Hamideh Pakniat, Venus Chegini, Azarmidokht Shojaei, Marzieh Beigom Khezri, Iman Ansari
Wichtige Hinweise
Hamideh Pakniat is a Assistant Professor of Department of Obstetrics and Gynecology, Qazvin University of Medical Sciences, Qazvin, Iran. Venus Chegini is a Assistant Professor of Department of Obstetrics and Gynecology, Qazvin University of Medical Sciences, Qazvin, Iran. Azarmidokht Shojaei is a Resident of Obstetrics and Gynecology, Student Research Committee, Faculty of medicine, Qazvin University of Medical Sciences, Qazvin, Iran. Marzieh Beigom Khezri is a Associated Professor of Department of Anesthesiology, Qazvin University of Medical Sciences, Qazvin, Iran. Iman Ansari is a Medical Students Research Committee, Shahed University, Tehran, Iran.

Abstract

Purpose

To evaluate the effects of intravenous tranexamic acid (TA) and sublingual misoprostol on reducing bleeding after cesarean section.

Materials

One hundred and fifty-eight participants with term pregnancies scheduled for cesarean section were randomly divided into two groups. In M group, two sublingual misoprostol pills (400 mg) were administrated, immediately after the delivery. In TA group, ten minutes before skin incision, TA ampoule (1 g) was injected. In both groups, immediately after the delivery, 20 units of oxytocin in 1 L ringer lactate with speed of 1000 CC/h was injected. At the end of the operation, the amount of bleeding was measured based on the number of small and large gauzes, the blood in the suction container and the difference of patient’s hemoglobin before and 24 h after surgery.

Results

Hemoglobin level reduction in the TA group was higher than the M group (− 2.45 ± 0.84 vs − 2.14 ± 1.38 g/dL) (P < 0.001). Furthermore, number of used gauze and blood suction in the TA group was significantly higher compared to sublingual misoprostol (4.67 ± 1.34 vs 3.25 ± 1.31 and 260.25 ± 79.06 vs 193.94 ± 104.79 cc, respectively) (P < 0.001). Mean blood pressure during the entire duration of surgery in the TA group decreased significantly as compared to the M group (P < 0.001).

Conclusion

Total bleeding was significantly lower in sublingual misoprostol as compared to the tranexamic acid group. Furthermore, in misoprostol group hemodynamic variables were stabilized greater than tranexamic acid group.

Registration Number

IRCT201708308611N6

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