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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.

Authors: Hind Abdul Khaliq --- Ban Hadi Hameed
Journal: Mustansiriya Medical Journal مجلة المستنصرية الطبية ISSN: 20701128 22274081 Year: 2016 Volume: 15 Issue: 3 Pages: 23-27
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

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.


Article
Comparison of Oral Misoprostol with Conventional Uterotonics in the Management of Third Stage of Labor

Authors: Hameedah Hadi --- Zahida A. Al- Saadi
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2019 Volume: 12 Issue: 1 Pages: 4103-4110
Publisher: Kerbala University جامعة كربلاء

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Abstract

background: Randomized prospective control study it is objective to compare effect of oral misoprostol with conventional uterotonics in the management of the third stage of labor.Aim of study: The incidence of Hemorrhage and the decrease in hemoglobin concentration is the main out comes of the trial. Secondary outcomes included the occurrences of sever postpartum hemorrhage.Patient and method: This study was done in Department of obstetrics and gynecology at Baghdad Teaching Hospital. In controlled trials a pregnant women total number 280 were randomized into four groups, as followed: Group I: received oral misoprostol 400 Mg, followed by two doses of oral misoprostol 100 Mg 4hours a part. (n=72), group 2: received intravenous infusion of oxytocin10 IU plus oral misoprostol 400 Mg followed by two doses of 100Mg oral misoprostol 4 hours apart group 3: received intravenous infusion of oxytocin 10 IU. (n=69), group 4: received intravenous infusion of 10 IU oxytocin plus intramuscular administration of methylergometrine (methergine) 0.2 mg. (n=77). The data of 40 women were excluded from the study because of loss to follow up, previous cesarean deliveries performed after randomization n=25, pre delivery hemoglobin was unavailable n= 10, postpartum percentage of hematocrit unavailable n=5. Main measures, the incidences of postpartum hemorrhage and the changes in hematocrit concentration from before delivery to 24 hours postpartum, in those women used oral misoprostol in management of third stage of labor with or without the use of other uterotonicsResult: Shows, Mean blood loss in misoprostol group was not significantly higher than blood loss in oxytocin group and oxytocin misoprostol group, but there was statistically significant difference when compared with oxytocin-methylergometrine group.Conclusion: Oral administrated misoprostol is as effective as conventional oxytocic in prevention of postpartum hemorrhage

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