Intravenous tranexamic acid vs. sublingual misoprostol in high-risk women for postpartum haemorrhage following cesarean delivery; a randomised clinical trial

ObjectiveThis study compares the effectiveness of administering sublingual misoprostol combined with oxytocin to that of IV tranexamic acid combined with oxytocin to reduce intra and post-operative blood loss in high-risk women for postpartum haemorrhage (PPH) following cesarean section (CS).Methods...

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Published in:BMC pregnancy and childbirth 2023-08, Vol.23 (1), p.1-611, Article 611
Main Authors: Dawoud, Mariam, Al-Husseiny, Maha, Helal, Omneya, Elsherbini, Moutaz, Abdel-Rasheed, Mazen, Sediek, Mona
Format: Article
Language:English
Subjects:
Acids
Antifibrinolytic agents
Blood
Cesarean section
Clinical trials
Developing countries
Expected values
Hemorrhage
Hormones
Hypotheses
LDCs
Maternal mortality
Misoprostol
Obstetrics
Oxytocin
Postpartum haemorrhage
Postpartum period
Pregnancy
Suctioning
Thromboembolism
Tranexamic acid
Variance analysis
Womens health
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Summary:ObjectiveThis study compares the effectiveness of administering sublingual misoprostol combined with oxytocin to that of IV tranexamic acid combined with oxytocin to reduce intra and post-operative blood loss in high-risk women for postpartum haemorrhage (PPH) following cesarean section (CS).MethodsAbout 315 high-risk pregnant women undergoing CS participated in this trial. They were randomly assigned into three groups; tranexamic group, misoprostol group, and control group, according to the medication given in the operative theatre. All patients received oxytocin intraoperatively. They were assessed regarding intraoperative blood loss, the incidence of PPH, and the reduction in haemoglobin and hematocrit values.ResultsBoth tranexamic and misoprostol groups had similar results in reducing intra and post-operative blood loss. However, the reduction in haemoglobin and hematocrit were significantly lower in tranexamic and misoprostol groups compared to the control group (-0.78 ± 0.57 vs. -0.83 ± 0.52 vs. -1.32 ± 0.57 gm/dl, P 
ISSN:1471-2393
1471-2393
DOI:10.1186/s12884-023-05935-5