الفهرس 
Postpartum HemorrhageOnly 14 pages are availabe for public view
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Abstract
Obstetric hemorrhage is the leading cause of
maternal morbidity and mortality. Caesarean section (CS)
rates have increased to 25 to 30 % in many areas of the
world.
In order to reduce maternal mortality and morbidity
caused by bleeding, it is important to reduce the amount of
bleeding during and after lower segment caesarean section
(LSCS).
Tranexamic acid is a synthetic derivative of the
amino acid lysine that exerts its antifibrinolytic effect
through the reversible blockade of the lysine binding sites
on plasminogen molecules. Also TXA may enhance the
effectiveness of patient‟s own hemostatic mechanism.
Thus our study was held on the steps of previous
studies to assess the efficiency of the use of tranexamic
acid preoperatively on decreasing intra- and post-operative
blood loss after elective Caesarean sections by estimation
of hemoglobin and hematocrit before and 12 hours after
operation.The current study was conducted in Obstetrics and
Gynecology department, Ain Shams maternity hospital in
the period from May 2017 to January 2018. The study was
conducted on 200 patients divided in to study group= 100
and control group =100. The study group was subjected to
1 gram of tranexamic acid given slowly intravenous
infusion 15-20 minutes before skin incision. After the
delivery of baby 10 IU of oxytocin was given in a 500 ml
Ringer lactate infusion.
The control group was subjected to 500 ml of 5%
dextrose in form of placebo slowly intravenous infusion.
After the delivery of baby 10 IU of oxytocin was given in a
500 ml Ringer lactate infusion.
All the included women ages from 20-35 years old
with singleton pregnancy, medically free with no allergy to
tranexamic acid and spinal anesthesia was used for all
women.
In the current study we excluded any medical
problems involving the heart, liver or kidney, neurological
disease, blood disorders, history of thromboembolic
disorders or pregnancy complications such as preeclampsia,
multiple pregnancies, polyhydramnios or placenta Previa,
intra-partum hge, postpartum hge, patients required blood transfusion also women with previous CS were excluded.
Patients who lost blood more than 1000 ml during the
cesarean section were excluded.
In the result of the current study a statistically
significant decrease in HCT and hemoglobin level has been
noticed in group A (placebo group) compared to group B
(TXA group). Blood loss during operation, Towel weight
gain and pads weight gain were significantly increased in
group A compared to group B.