الفهرس 
The efficacy and safety of preoperative intravenous tranexamic acid versus sublingual misoprostol in reducing blood loss during and after elective cesarean section among high risk pregnant cases
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Abstract
Objective. to compare the efficacy and safety of preoperative Tranexamic Acid versus Sublingual Misoprostol in the reduction of blood loss during and after elective lower segment cesarean delivery among high risk pregnant cases. Methodology: 345 pregnant women, candidate for LSCS, were equally randomized into 3 groups: oxytocin group received an intravenous bolus of 5IU oxytocin and 20IU oxytocin in 500mL lactated Ringer{u2019}s following the delivery of the baby, Tranxemic acid group(patients will be given 1 gm (10ml) TXA diluted in 20ml of Glucose 5% (administered as intravenous infusion over 5 minutes, at least 15 minutes prior to skin incision) and Misoprostol group 400 microgram misoprostol will be administered sublingually by the patients immediately before starting skin incision. Following the delivery of the baby, patients in both Tranexamic and Misoprostol groups will additionally receive an intravenous bolus of 5IU oxytocin and 20IU oxytocin in 500mL lactated Ringer{u2019}s solution (infused at a rate of 125mL/h). The 1ry outcome was the estimated blood loss (EBL) during cesarean delivery and 2ry outcomes included the occurrence of excessive blood loss (>1000mL) within the first 24 hours postoperatively and the occurrence of any maternal or fetal side effects. Results our results demonstrated that Patients in the oxytocin group experienced a significantly more mean blood loss, a larger number of soaked towels was used, significantly heavier weight difference of soaked towels, had significantly higher mean in blood loss in suction when compared with patients in tranexamic acid group and misoprostol group