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

Abstract

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 2015-2016. The study population included all candidates for cesarean section. 300 pregnant women aged 18-40 years with gestational age of 37-42 weeks were included, divided into three groups each: A received tranexamic acid,B, misoprostol, and C, 200 cc normal saline. During C/S , all patients received 20 and 30 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 11.96±1mg/dl in the groupA,11.62±1.21mg/dl in the groupB, and 12.28±1.26mg/dl in the placebo group, which was statistically significant (P=0.001). Postoperative hemoglobin level was reduced about 1.02±0.35(10.9 ±0.99mg/dl) in the groupA, 1.19±0.52(10.46±1.04mg/dl) in the groupB, and 1.36±0.50(10.93±1.34mg/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