الفهرس 
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Abstract
The rate of cesarean section has increased in recent decades in both
developed & developing countries. Postpartum Hemorrhage (PPH) is
considered one of the most common complications of CS and accounts for the
major part of the mortality as well as morbidity like severe anemia, need for
blood transfusion, hospital stay and infection.
Therefore, we designed this prospective randomized study to evaluate the
effectiveness of early administration of Tranexamic Acid in reducing blood loss
during elective Cesarean section.
A prospective, randomized clinical study was conducted at Menuofia
University on 100 patients divided into two groups,
In group (A), pregnant women who received 1gm of tranexamic acid 20
minutes before skin incision.
In group (B), pregnant women who did not receive tranexamic acid
before skin incision.
Evaluation of the following was done:
Blood loss using gravimetric measurement intraoperative and 2 hours
postoperative.
Postoperative 1st day hemoglobin and hematocrit value (g/dl):
Hemoglobin and HCT estimation was done within 24 hours after the
surgery (after discontinuation of IV fluids) for all the women and
compared with the preoperative value.
Postoperatively all cases were monitored for 2 hours. Vitals (heart rate,
blood pressure, oxygen saturation, urine output, uterine contractility
status, and side effects if any was noted at regular intervals. Apart from
routine postoperative care, all women were observed for any increased
Summary
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bleeding per vaginum and additional pre weighed pads were provided along with measures to reduce bleeding if needed.
Results of the current study were as follow:
This study showed highly statistically significant difference between study group and control group regarding the blood loss during cesarean delivery and blood loss 2 hours after end of CS (p≤ 0.001) with a total amount of blood loss ranges between (318-556) in study group compared to control group , which ranges between (463-769) with a highly statistically significant difference between both groups (p≤ 0.001).
Additionally, a highly significant statistical difference (p≤ 0.001) was shown between two groups in the following secondary outcomes: percentage of difference in hemoglobin and hematocrit values pre & postoperative with a mean preoperative Hb level 10.36 gm/dl in study group and 10.26 gm/dl in control group which shows no statistical difference before onset of CS.
Based on the result of this study, prophylactic administration of TXA before CS is associated with reduction in intra and postoperative blood loss with no immediate maternal or neonatal adverse effects.