THE EFFECT OF TRANEXAMIC ACID ON REDUCING THE AMOUNT OF BLOOD LOSS DURING CESAREAN SECTION AT MATERNITY HOSPITAL IN DUHOK

Background:The Cesarean section rate is increasing worldwide.Efforts are being made to decrease Cesarean section which may lead to many complications.World Health Organization recent guidelines recommended the administration of Tranexamic acid to decrease the amount of blood loss and treat postpartum hemorrhage to reduce the risk of severe anemia and the need for blood transfusion.Objectives: To assess the effect of Tranexamic acid on the amount of blood loss during elective cesarean section and to evaluate the reduction in the hemoglobin and hematocrit level.Methods: This randomized control trial study was conducted during the period from 15th September 2021 to 15 th January 2022, at Duhok Hospital for Obstetrics and Gynecology.The study enrolled 200 women in the age group 20 to 40 years, who were at 37 to 41+6 weeks of gestation, received regular antenatal care, had no renal, liver, heart diseases or coagulopathies and no allergy to drugs.The women were randomly allocated into two groups the interventional group G1 received 1 gm of Tranexamic acid in 100 ml normal saline for 10 minutes before starting the operation and the control group G2 did not receive it.Both groups received 10 units oxytocin IV after fetal delivery.Amount of blood loss intraoperatively, change in hemoglobin, hematocrit levels, drug side effects were observed and analyzed, and the need for extra uterotonics, blood transfusion and the occurrence of PPH among the two groups.Results: There were no significant differences in term of age, BMI, parity, gestational age, antenatal care visits, and the indications for cesarean section between G1 and G2.There was a highly significant difference in the mean estimated blood loss (EBL) between the two Groups, which was (290±5.5 ml) for G1 and (429±81 ml) for G2, the P-value <0.001.The same for the mean Hb and hematocrit reduction with a highly significant between the two Groups, P-value <0.001.The need for extra uterotonics drugs was less in G1 compared to G2. Conclusion: Administration of IV Tranexamic acid as a prophylaxis before starting skin incision significantly reduced the amount of blood loss intra operatively, and affected hemoglobin, hematocrit level.It deceased the need for extra uterotonics drugs.