Comparing Intramyometrial Tranexamic Acid and Oxytocin for Blood Loss in Cesarean Section
Cesarean Section Complications, Tranexamic Acid, Oxytocin
About this trial
This is an interventional prevention trial for Cesarean Section Complications
Eligibility Criteria
nclusion Criteria: Women booked for a primary elective cesarean section, not in active labor Aged between 20-40 years. BMI 18.5-29.9 kg/ m2 pre-pregnancy weight Term pregnancies (Early term: between 37 weeks, 0 days and 38 weeks, 6 days. Full term: between 39 weeks, 0 days and 40 weeks, 6 days. Late term: between 41 weeks, 0 days and 41 weeks, 6 days). Singleton pregnancies. Indication of elective cesarean section (Malpresentation, Malposition, Cephalopelvic disproportion, active herpes) Fetal macrosomia (Macrosomia is defined as birth-weight over 4,000 g irrespective of gestational age) Certain congenital fetal malformation and skeletal disorders (Several congenital anomalies are controversial indications for cesarean delivery; these include fetal neural tube defects (to avoid sac rupture), particularly defects that are larger than 5-6 cm in diameter as anterior cystic hygroma vascular sacrococcygeal teratoma, giant omphalocele and hydrocephalus with an enlarged biparietal diameter, and some skeletal dysplasia such as type III osteogenesis imperfecta. (Hamrick et al., 2008) Exclusion Criteria: Placenta previa. Maternal hypertension and Preeclampsia. Diabetes mellitus. Severe medical disorder (renal or hepatic). Multiple Fibroid uterus. Multiple pregnancies. Polyhydramnios. Previous uterine surgery as myomectomy. Contraindication to spinal anesthesia. Blood coagulopathy and bleeding disorder. Marked maternal anemia (Preoperative hemoglobin <9 gm/dl). Contraindications to TXA or oxytocin therapy (e.g. allergy)
Sites / Locations
- faculty of medicine - Cairo universityRecruiting
Arms of the Study
Arm 1
Arm 2
Experimental
Experimental
Group 1: Tranexamic acid group
Group 2: oxytocin group
In TXA group (n=25): 1 g from tranexamic acid (kapron®, Amoun, Egypt) shall also be watered down in 10 cc of Saline, and 5 cc shall be injected in each uterine corn before the placenta is separated.
to the oxytocin group (n = 25): 5 I.U of oxytocin (syntocinone 5 I.U/1ML NONARTIS-EGYPT) shall be watered down in 10 cc of saline, and 5 cc shall be injected into each uterine corn before the placental separation