Investigating and Comparing the Therapeutic Effect of Tranexamic Acid and Oxytocin in Control of Postpartum Hemorrhage Following Uterine Atony after Cesarean Section: A Randomized Clinical Trial

Background and

Uterine atony is responsible for 75-90% of postpartum hemorrhage, which will increase the probability of maternal mortality if proper measures are not taken to correct it. The aim of this study was to determine the therapeutic effect of tranexamic acid along with oxytocin in controlling postpartum hemorrhage.

This clinical trial study was performed on 142 pregnant women referring to Imam Sajjad Hospital in Yasouj for delivery in 2019-2020. Patients were randomly divided into two groups. The intervention group (71 people) received an ampoule of oxytocin at the rate of 40 units per liter of Ringer's serum and an ampoule of tranexamic acid at the rate of one gram per 10 cc of normal saline in a slow intravenous manner for 1 minute. The control group (71 people) received 40 units of oxytocin in one liter of serum and 10 cc of normal saline as a slow intravenous infusion for 1 minute. Then, the bleeding volume was evaluated based on the weight of gas consumed, the volume of blood collected, and the number of red blood cells received in both groups. Descriptive statistics of ratio comparison tests (chi-square) and t-test were used for data analysis.

The decrease of hemoglobin in the intervention group was significantly lower than the control group (P=0.007). The average change in gas weight at the end of the operation was higher in the control group (602.7±66.8) compared to the intervention group (571.7±81)(P=0.014). Also, the average bleeding volume and the number of blood bags received in the control group were higher than the intervention group, however, no significant relationship was observed (P>0.05).

Administering tranexamic acid together with oxytocin, in the case of uterine atony, may be more effective than oxytocin alone in controlling postpartum bleeding during cesarean section.