A Double Blinded Randomised Clinical Trial to Compare the Effect of Intravenous Tranexamic Acid and Misoprostol for Postpartum Haemorrhage
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 1, Pages 539-545
AbstractAim: Comparison effect of intravenous tranexamic acid and misoprostol for postpartum haemorrhage.
Methods: This double blinded randomised clinical trial study was done the Department of Obstetrics and Gynaecology, Hi-Tech Medical College, Rourkela, Odisha, India from February 2021 to November 2021. 80 women with PPH (500-1500 ml) diagnosis after caesarean or normal delivery, according to their haemorrhage level after usual therapies for controlling haemorrhage, after getting consent were included in the study. They were divided into two equal intervention and control groups randomly. Patients in group A were treated with intravenous TXA and patients in group B with rectal Misoprostol. Intervention group (group A) which were receiving intravenous TXA (1gr) and if there was relieve in haemorrhage, next TXA dose was repeated after 30 minutes and in patients of control group (group B) after usual therapies, 5 rectal 200 micrograms Misoprostol pills were used. The bladder was emptied before therapy in both groups.
Results: Mean age of all studied patients was 27.7 ± 5.5 years which ranged from 15 to 41 years. As distinct groups mean age of women in group A, was 28.1 ± 5.3 years and in group B it was 27.7 ± 5.8 years. Mean age difference between two groups of under study patients was not statistically significant (P = 0.87). Based on sonography mean gestational age in group A, was 37.8 ± 3.5 and in group B, was 37.5 ± 3.4 weeks. Difference of two groups in terms of gestational age and amount of haemorrhage, was not statistically significant (P = 0.34 and P = 0.47 respectively). In group A, natural vaginal delivery (NVD) was performed, while in group B there in 38 patients (95%) NVD and in 2 patients (5%) caesarean delivery was performed. According to analysis, the difference between two groups was not statistically significant considering mentioned aspects. NVD in 30 cases (75%) in group A and in 36 patients (90%) in group B, was together with episiotomy or laceration and its difference was statistically significant (P = 0.003). Mean massaging time for patients in group A was 25 ± 17.9 minutes and in group B, was 25.5 ± 13.6 minutes. In terms of clinical consequence, 37 patients (92.5%) in group A and 36 patients in group B were discharged without any specific problem.
Conclusions: It is possible to state that misoprostol has no specific preference over TXA, but it is better to investigate its effect with other studies with more sample size and associated with misoprostol.
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