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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. |