Comparison the effect of intravenous Tranexamic Acid and sublingual Misoprostol and Oxytocin to reducing of post- cesarean hemorrhage

Comparison the effect of intravenous Tranexamic Acid and sublingual Misoprostol and Oxytocin to reducing of post- cesarean hemorrhage. Design:Randomized double blind clinical trial. Setting and conduct: All subjects will randomly devide in two groups of 75 and therapeutic interventions perform. Inclusion criteria are singleton pregnant women with 37- 40 weeks gestational ages, first gravida and maximum second gravida,previous cesarean section with lower segment incision. Exclusion criteria are preeclampsia, abnormal placenta, previous uterine rupture. Intervention: First group will receive 400 micrograms of sublingual Misoprostol after removing placenta.Second group,will injected 1gr of intravenous Tranexamic Acid into 20 c.c of 5% Dextrosewaters slowly before begining cesarean and both groups will receive 20 Units of Oxytocin after removing placenta immediatly. The volume of bleeding will measured by the bottle of suction set after removing placenta,the weight of cesarean set, consumed gases during the cessrean section. The blood pressure and pulse rate will be measured every 5 minutes during the section and every 30 minutes up to an hour after cesarean. Hemoglobin will be measured at the time of entering the ward and 24 hours after cesarean. One hour after cesarean occurrence of side effects such as fever, nausea, shivering will be evaluated. Patients up to 24 hours after cesarean will be monitored and in the event of sever bleeding an uterotonic drugs will be used. Main outcome measures: Hemoglobin values and volume of bleeding during cesarean section.

Vice Chancellor for Research and technology, Qazvin University of Medical Sciences