scholarly journals Tranexamic Acid and Ethamsylate for Reducing Blood Loss in Patient Undergoing Lower Segment Cesarean Section at High Risk for Post-Partum Hemorrhage: A Pilot Study

2020 ◽  
Vol 10 (09) ◽  
pp. 1340-1350
Author(s):  
Ahmed Alanwar ◽  
Marwan M. Gamal
Keyword(s):  
Pilot Study ◽  
High Risk ◽  
Blood Loss ◽  
Cesarean Section ◽  
Tranexamic Acid ◽  
Post Partum ◽  
Lower Segment ◽  
Post Partum Hemorrhage ◽  
Lower Segment Cesarean Section

scholarly journals Prophylactic Tranexamic acid usage in Prevention of Post-Partum Hemorrhage a Prospective Cohort Study

2019 ◽  
Author(s):  
Seifeldin Sadek ◽  
Arnold M Mahesan ◽  
Hadi Ramadan ◽  
Nimra Dad ◽  
Vani Movva ◽  
...  
Keyword(s):  
Cohort Study ◽  
High Risk ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Post Partum ◽  
Secondary Outcome ◽  
Post Partum Hemorrhage ◽  
Estimated Blood Loss

Abstract Background Post-partum hemorrhage (PPH) is the leading cause of obstetric morbidity and mortality around the world. Prophylactic administration of tranexamic acid (TXA) in patients at risk for PPH is aimed at reducing estimated blood loss (EBL). Method This was a prospective cohort study. Patients at high risk of PPH were given 1000mg of TXA intravenously at cord clamping after delivery of the baby, and compared with high PPH risk controls who did not receive TXA. Both cesarean section deliveries (CD) and vaginal deliveries (VD) were included. The primary outcome was postpartum hemorrhage, and the secondary outcome was calculated estimated blood loss (cEBL). Results Between January 2017 and May 2017, 101 patients at high risk for PPH were enrolled. Fifty one received TXA and 50 did not. There were 20 cases of PPH in the TXA group compared with 30 cases in the control group (OR 0.43, 95% CI, NNT=5). The average cEBL for VD and CD were significantly lower in the patients who received TXA compared with controls: 561ml ±336ml compared with 841ml ±462ml (p=0.0006) for VD and 658ml ±294mL compared with 1024ml ±276 for CD (p=0.0007). Conclusions Intravenous TXA may be used as prophylaxis for PPH in obstetric patients at high risk.

scholarly journals Assessment the role of tranexamic acid in prevention of postpartum hemorrhage

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Nevein Gerges Fahmy ◽  
Fahmy Saad Latif Eskandar ◽  
Walid Albasuony Mohammed Ahmed Khalil ◽  
Mohammed Ibrahim Ibrahim Sobhy ◽  
Amin Mohammed Al Ansary Amin
Keyword(s):  
Blood Loss ◽  
Cesarean Section ◽  
Tranexamic Acid ◽  
Postpartum Hemorrhage ◽  
Postoperative Bleeding ◽  
Control Group ◽  
Study Group ◽  
Mortality And Morbidity ◽  
Lower Segment Cesarean Section ◽  
Prophylactic Use

Abstract Background Postpartum hemorrhage (PPH) is one of the leading causes of maternal mortality and morbidity worldwide. It is believed that hemostatic imbalance secondary to release of tissue plasminogen activator (tPA) and subsequent hyperfibrinolysis plays a major role in PPH pathogenesis. Antifibrinolytic drugs such as tranexamic acid (TXA) are widely used in hemorrhagic conditions associated with hyperfibrinolysis. TXA reduced maternal death due to PPH and its use as a part of PPH treatment is recommended, and in recent years, a number of trials have investigated the efficacy of prophylactic use of TXA in reducing the incidence and the severity of PPH. The study is aiming to assess the efficacy of tranexamic acid in reducing blood loss throughout and after the lower segment cesarean section and reducing the risk of postpartum hemorrhage. Results The amount of blood loss was significantly lower in the study group than the control group (416.12±89.95 and 688.68±134.77 respectively). Also the 24-h postoperative hemoglobin was significantly higher in the study group (11.66±0.79 mg/dl) compared to the control group (10.53±1.07mg/dl), and the 24-h postoperative hematocrit value was significantly higher in the study group (34.99±2.40) compared to control (31.62±3.22). Conclusion Prophylactic administration of tranexamic acid reduces intraoperative and postoperative bleeding in cesarean section and the incidence of postpartum hemorrhage.

scholarly journals Timing of oxytocin administration to prevent post-partum hemorrhage in women delivered by cesarean section: A systematic review and metanalysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0252491
Author(s):  
Maria Regina Torloni ◽  
Monica Siaulys ◽  
Rachel Riera ◽  
Ana Luiza Cabrera Martimbianco ◽  
Rafael Leite Pacheco ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Blood Loss ◽  
Cesarean Section ◽  
Post Partum ◽  
Average Risk ◽  
Limited Evidence ◽  
Post Partum Hemorrhage ◽  
Uterine Incision ◽  
Mean Differences ◽  
Calculated Average

Background There is no consensus on the best timing for prophylactic oxytocin administration during cesarean section (CS) to prevent post-partum hemorrhage (PPH). Objectives Assess the effects of administrating prophylactic oxytocin at different times during CS. Methods We searched nine databases to identify relevant randomized controlled trials (RCT). We pooled results and calculated average risk ratios (RR), mean differences (MD), and 95% confidence intervals (CI). We used GRADE to assess the overall evidence certainty. Results We screened 13,389 references and included four trials. We found no statistically significant differences between oxytocin given before versus after fetal delivery on PPH (RR 0.60, 95%CI 0.15–2.47; 1 RCT, N = 300) or nausea/vomiting (RR 1.21, 95%CI 0.69–2.13; 1 RCT, N = 300). There was a significant reduction in the need for additional uterotonics when oxytocin was given immediately before uterine incision versus after fetal delivery (RR 0.37, 95%CI 0.18–0.73; I2 = 0%; 2 RCTs; N = 301). Oxytocin given before fetal delivery significantly reduced intra-operative blood loss (MD -146.77mL, 95%CI -168.10 to -125.43; I2 = 0%; 3 RCTs, N = 601) but did not change the incidence of blood transfusion (RR 0.50, 95%CI 0.13–1.95; I2 = 0%; 2 RCTs, N = 301) or hysterectomy (RR 3.00; 95%CI 0.12–72.77; I2 = 0%; 2 RCTs, N = 301). One trial (N = 100) compared prophylactic oxytocin before versus after placental separation and found no significant differences on PPH, additional uterotonics, or nausea/vomiting. Conclusions In women having pre-labor CS, there is limited evidence indicating no significant differences between prophylactic oxytocin given before versus after fetal delivery on PPH, nausea/vomiting, blood transfusion, or hysterectomy. Earlier oxytocin administration may reduce the volume of blood loss and need for additional uterotonics. There is very limited evidence suggesting no significant differences between prophylactic oxytocin given before versus after placental separation on PPH, need for additional uterotonic, or nausea/vomiting. The overall certainty of the evidence was mostly low or very low due to imprecision. Protocol: CRD42020186797.

scholarly journals A randomized controlled trial of sublingual Misoprostol - 600µg versus intravenous Oxytocin - 10IU in prevention of post partum hemorrhage during cesarean section

2019 ◽  
Vol 8 (10) ◽  
pp. 3865 ◽  
Author(s):  
Rajasri G. Yaliwal ◽  
Shailaja R. Bidri ◽  
Ashwini S. Navani
Keyword(s):  
Blood Loss ◽  
Cesarean Section ◽  
Late Onset ◽  
Post Partum ◽  
Common Side Effect ◽  
Suitable Alternative ◽  
Post Partum Hemorrhage ◽  
Emergency Cesarean ◽  
Estimated Blood Loss ◽  
Sublingual Misoprostol

Background: Mortality related to pregnancy and childbirth causes half a million women around the world to die annually. About 35% of these deaths are from postpartum hemorrhage (PPH). Prevention of PPH has been advised by the WHO by the use of Oxytocin 10 IU IM or IV and Misoprostol 600 µg in low resource settings in vaginal delivery. However there have been only a few reports on the use of Misoprostol during cesarean section. The best route and dose of Misoprostol is still being debated.Methods: One hundred women with term singleton pregnancy undergoing elective or emergency cesarean section under spinal anesthesia were randomly allocated to receive either Misoprostol 600µg sublingually or intravenous oxytocin 10 IU soon after delivery of the baby. Estimated blood loss and comparative change in preoperative hemoglobin to post operative hemoglobin levels and side effects were evaluated.Results: Blood loss was found to be more in Misoprostol than Oxytocin. Eight patients of the Misoprostol group required additional oxytocics. Oxytocin group did not receive any additional drugs. No surgical intervention was made in either of the groups.  The most common side effect with Misoprostol was shivering (46%) and in Oxytocin group fever (4%).Conclusions: Sublingual Misoprostol of 600µg works to prevent postpartum bleeding. In our study Oxytocin was more effective than Misoprostol in preventing PPH during cesarean section. Late onset of action of Misoprostol in comparison to Oxytocin may render suturing of the uterus difficult due to pooling of blood. In settings in which use of Oxytocin is not feasible, Misoprostol might be a suitable alternative for post-partum hemorrhage.

scholarly journals A Case of Post-partum Chronic Subdural Hematoma.

2021 ◽  
Author(s):  
Suyasha Rajbhandari ◽  
Pritam Gurung ◽  
Gopi Nepal ◽  
Samir Acharya ◽  
Basant Pant
Keyword(s):  
Cesarean Section ◽  
Spinal Anesthesia ◽  
Subdural Hematoma ◽  
Dural Puncture ◽  
Post Partum ◽  
Chronic Subdural Hematoma ◽  
Lower Segment ◽  
Post Dural Puncture Headache ◽  
Lower Segment Cesarean Section ◽  
Variable Presentation

Intracranial subdural hematoma following spinal anesthesia is an infrequent occurrence and has variable presentation. Due to rarity, it may often be misdiagnosed as post-dural puncture headache. In this report, we describe a case of a 25-year-old woman who presented with a headache following lower segment cesarean section after spinal anesthesia.

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