The effect of pre-operative intravenous tranexamic acid versus rectal misoprostol in reducing blood loss during and after elective cesarean section in primigravida: A double-blinded, randomized, comparative-placebo trial.

To compare the effectiveness of preoperative intravenous tranexamic acid and rectal misoprostol in reducing post-cesarean section blood loss.In the randomized controlled trial, two groups were formed from 200 pregnant women undergoing elective cesarean sections. The tranexamic acid group received a 1 g intravenous injection of tranexamic acid 10 minutes before skin incision, whereas the misoprostol group received 800 mcg of rectal misoprostol preoperatively. Both groups received 20 units of oxytocin in a 500 ml ringer lactate intravenous infusion at a rate of 125 ml/h after delivery. Blood loss was assessed by measuring the number of gauzes used, the amount of blood in the suction container, and changes in hemoglobin and hematocrit levels before and after surgery.Blood loss in tranexamic acid was 906.36 ± 75.34 vs. 778.01 ± 94.96 ml in the misoprostol group (P < 0.0001) and change in hemoglobin and hematocrit was less in the misoprostol group (P < 0.0001).Misoprostol is more effective than tranexamic acid in reducing blood loss during and after cesarean sections.