Hamideh Pakniat1, Venus Chegini1, Azarmidokht Shojaei2, Marzieh Beigom Khezri3, Iman Ansari4. 1. 1Department of Obstetrics and Gynecology, Qazvin University of Medical Sciences, Qazvin, Iran. 2. 2Faculty of Medicine, Qazvin University of Medical Sciences, Qazvin, Iran. 3. 3Department of Anesthesiology, Qazvin University of Medical Sciences, Shahid Bahonar Ave, PO Box 3419759811, Qazvin, Iran. 4. 4Shahed University, Tehran, Iran.
Abstract
PURPOSE: To evaluate the effects of intravenous tranexamic acid (TA) and sublingual misoprostol on reducing bleeding after cesarean section. MATERIALS: One hundred and fifty-eight participants with term pregnancies scheduled for cesarean section were randomly divided into two groups. In M group, two sublingual misoprostol pills (400 mg) were administrated, immediately after the delivery. In TA group, ten minutes before skin incision, TA ampoule (1 g) was injected. In both groups, immediately after the delivery, 20 units of oxytocin in 1 L ringer lactate with speed of 1000 CC/h was injected. At the end of the operation, the amount of bleeding was measured based on the number of small and large gauzes, the blood in the suction container and the difference of patient's hemoglobin before and 24 h after surgery. RESULTS: Hemoglobin level reduction in the TA group was higher than the M group (- 2.45 ± 0.84 vs - 2.14 ± 1.38 g/dL) (P < 0.001). Furthermore, number of used gauze and blood suction in the TA group was significantly higher compared to sublingual misoprostol (4.67 ± 1.34 vs 3.25 ± 1.31 and 260.25 ± 79.06 vs 193.94 ± 104.79 cc, respectively) (P < 0.001). Mean blood pressure during the entire duration of surgery in the TA group decreased significantly as compared to the M group (P < 0.001). CONCLUSION: Total bleeding was significantly lower in sublingual misoprostol as compared to the tranexamic acid group. Furthermore, in misoprostol group hemodynamic variables were stabilized greater than tranexamic acid group. REGISTRATION NUMBER: IRCT201708308611N6.
PURPOSE: To evaluate the effects of intravenous tranexamic acid (TA) and sublingual misoprostol on reducing bleeding after cesarean section. MATERIALS: One hundred and fifty-eight participants with term pregnancies scheduled for cesarean section were randomly divided into two groups. In M group, two sublingual misoprostol pills (400 mg) were administrated, immediately after the delivery. In TA group, ten minutes before skin incision, TA ampoule (1 g) was injected. In both groups, immediately after the delivery, 20 units of oxytocin in 1 L ringer lactate with speed of 1000 CC/h was injected. At the end of the operation, the amount of bleeding was measured based on the number of small and large gauzes, the blood in the suction container and the difference of patient's hemoglobin before and 24 h after surgery. RESULTS: Hemoglobin level reduction in the TA group was higher than the M group (- 2.45 ± 0.84 vs - 2.14 ± 1.38 g/dL) (P < 0.001). Furthermore, number of used gauze and blood suction in the TA group was significantly higher compared to sublingual misoprostol (4.67 ± 1.34 vs 3.25 ± 1.31 and 260.25 ± 79.06 vs 193.94 ± 104.79 cc, respectively) (P < 0.001). Mean blood pressure during the entire duration of surgery in the TA group decreased significantly as compared to the M group (P < 0.001). CONCLUSION: Total bleeding was significantly lower in sublingual misoprostol as compared to the tranexamic acid group. Furthermore, in misoprostol group hemodynamic variables were stabilized greater than tranexamic acid group. REGISTRATION NUMBER: IRCT201708308611N6.
Authors: Haleema Shakur; Ian Roberts; Raúl Bautista; José Caballero; Tim Coats; Yashbir Dewan; Hesham El-Sayed; Tamar Gogichaishvili; Sanjay Gupta; Jorge Herrera; Beverley Hunt; Pius Iribhogbe; Mario Izurieta; Hussein Khamis; Edward Komolafe; María-Acelia Marrero; Jorge Mejía-Mantilla; Jaime Miranda; Carlos Morales; Oluwole Olaomi; Fatos Olldashi; Pablo Perel; Richard Peto; P V Ramana; R R Ravi; Surakrant Yutthakasemsunt Journal: Lancet Date: 2010-06-14 Impact factor: 79.321
Authors: Jerrold H Levy; Richard P Dutton; J Claude Hemphill; Aryeh Shander; David Cooper; Michael J Paidas; Craig M Kessler; John B Holcomb; Jeffrey H Lawson Journal: Anesth Analg Date: 2009-12-10 Impact factor: 5.108