Efficacy of Oxytocin Infusion Versus Tranexamic Acid Infusion in Controlling Blood Loss During Elective Lower Segment Caesarean Section

Hassan, Nashwa Elsaid; Elghareeb, Nermeen Ahmed Mostafa; Zaki, Fady Makram

doi:10.21608/ejhm.2020.120453

Efficacy of Oxytocin Infusion Versus Tranexamic Acid Infusion in Controlling Blood Loss During Elective Lower Segment Caesarean Section

Document Type : Original Article

Authors

Department of Obstetrics and Gynecology, Faculty of Medicine- Ain Shams University

10.21608/ejhm.2020.120453

Abstract

Background: Caesarean section represents a risk factor for intrapartum and postpartum hemorrhages and a burden of ongoing anemia. Therefore, methods of controlling blood loss during caesarean section decrease maternal morbidity and mortality and enhance the quality of mother's life during puerperium.
Objective: to compare efficacy of oxytocin infusion after oxytocin bolus and efficacy of tranexamic acid infusion after oxytocin bolus in controlling blood loss during elective lower segment caesarean section.
Patients and methods: The study included 138 legally adult pregnant women (18 – 38 years old) with singleton pregnancies at term (37 – 42 weeks) who were recruited from Ain Shams University Maternity Hospital where and booked for primary elective caesarean section. They were randomly divided into three groups. Group (A) was given an intravenous slow bolus of oxytocin 10 IU over 1 minute and 40 IU oxytocin in 500 l of 0.9% saline solution over 4 hours after delivery of baby. Group (B) was given 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. Group (C) was given only an intravenous slow bolus of oxytocin 10 IU over 1 minute after delivery of baby. The three groups would be compared regarding to gravimetric assessment of “measured” blood loss and mathematical estimation of “calculated” blood loss. Results: The estimated and calculated blood loses in group (A) were statistically insignificant less than those in group (B). But those loses in group (C) were statistically significant more than the loses in other groups.
Conclusion: The tranexamic acid infusion after oxytocin bolus is effective as oxytocin infusion after oxytocin bolus in controlling blood loss during elective lower segment caesarean section. It can help against postpartum hemorrhage with no considerable side effects.

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