The effect of pre-operative intravenous Cyklokapron on the amount of blood loss during and after caesarean section for anemic patients At Al Yarmouk teaching hospital in Baghdad.


Back ground: caesarean section carries significant morbidity and mortality over vaginal delivery. Anemia with hemorrhagic complications add significantly for this morbidity and mortality. Aim of the study: to assess the effectiveness of Cyklokapron in reducing the intra-operative blood loss at time of caesarean section and postpartum hemorrhage in anemic patients and to evaluate its safety when used prophylactically. Patients and method: A hundred pregnant women aged 19 - 41 years with term gestation were recruited in this randomized, case control, prospective therapeutic trial, which was conducted for a period of one year at Al Yarmouk teaching hospital Baghdad Iraq, the participants were admitted for caesarean section. They were divided randomly into two groups; the study group 50 patients received intravenous Cyklokapron pre-operatively and a control group matched for the indication of caesarean section, the intra-operative, post-operative blood loss and hematocrit were evaluated and compared for both groups. Results: The intra-operative blood loss was measured in both groups, the total loss was significantly lower in the study group (170.12 ± 68.4 ml) compared to the control group (420.39 ± 130.6 ml) as P value was 0.0001 Concerning the post-operative blood loss, it was comparable in both groups and blood transfusion was required for two patients in the control group because of severe anemia (hemoglobin less than 8 gmdl) with no transfusion in the study group and this difference was not significant statistically. The mean reduction in hematocrit was significantly lower in the study group compared to control group (1.52 ± 0.81%) versus (2.58±0.85%) respectively and P value was less than 0.05 Conclusion and recommendations: The current study revealed that Cyklokapron is significantly effective in reducing blood loss at time of caesarean section. We recommend further studies with higher doses and more patients to evaluate its effect in reducing the intra-operative loss and preventing postpartum hemorrhage.