Comparison between local application on placental bed versus systemic injection of tranexamic acid in elective cesarean section

Abstract

Background: Obstetric hemorrhage continues to be a significant factor contributing to maternal mortality in both industrialized and developing nations. Obstetric hemorrhage, which includes both ante-partum and postpartum hemorrhages, is a significant contributor to maternal mortality and morbidity. Therefore, it is crucial to thoroughly examine this issue to produce national guidelines. Aim: to compare the hemostatic efficacy of local application of tranexamic acid on placental bed is versus systemic injection to prevent the postpartum hemorrhage. Methods: This research was a prospective randomized clinical trial done at the Department of Obstetrics and Gynecology at Tanta University Hospital including 100 pregnant cases. Results: There was statistically significant difference between two studied groups regarding Post-operative Hemoglobin, Hemoglobin change, post-operative basal Hematocrit and Hematocrit change (p< 0.05), while there was no statistically significant difference regarding Basal Hemoglobin, and Basal Hematocrit (p> 0.05). Conclusion: Administering tranexamic acid intravenously before making an incision in the skin or applying it topically on the placental bed after delivering the placenta in patients having a cesarean section greatly decreases the amount of blood lost during the operation.