The present randomized, double blind clinical experiment was carried out in 2013-14 at Shariati Hospital of Bandar Abbas, Iran. Two hundred pregnant women who visited this hospital and volunteered to have a cesarean surgery participated in this research. All women between 20 to 40 years of age who were in their 37th to 40th week of pregnancy and had opted for a cesarean surgery entered the study. The following were excluded: those with an experience of twinning; placenta abnormalities; severe pre-eclampsia; macrosomy; polyhydramnios; previous cesarean or abdominal surgeries; kidney, brain, blood or liver disorders; coagulopathy; anemia; thrombophilia; thromboembolic disorders; allergy to Tranexamic acid. In addition, patients whose BMI was higher than 30 were excluded from the study.
At the outset, all patients would get the required and adequate information about this research, and can only enter the study with full consent.
On entering the research, patients equally divided into two groups following a blocked randomization.
In the intervention group, with the help of an anesthesiologist, 20 minutes before the cesarean surgery 10 milligrams of Tranexamic acid for each kilogram of body mass combined with 200 milliliters of normal saline slowly injected within 5 minutes. Patients in the control group received only 200 milliliters of normal saline within 5 minutes. Neither the patient nor the researcher would be informed of the type of group. After the surgery all patients received 10 units of Tranexamic acid injected along with 500 milliliters of normal saline within 20 minutes. Moreover, all patients also received 30 units of oxytocin within the first 8 hours of the surgery. In the case of atonic uterus, 10 more units of oxytocin infusion added. Weight of blood gases and surgical sheets before and after use recorded. It needs to be reminded that amniotic fluid and the blood emerged due to skin incision and abdominal layers would be gathered in another suction and did not enter our estimations. The amount of the blood lost estimated 2 hours after the delivery (based on the difference of the weight of the tampon used). At the outset of the surgery, a tampon was inserted into the vagina, the difference of its weight before the surgery and 2 hours after the surgery was calculated. Therefore, the amount of bleeding is estimated. Hb was checked 24 hours after the cesarean surgery. In case, the level of hemoglobin is lower than 8, blood transfusion was done.