Prophylactic Effect of Misoprostol Versus Tranexamic Acid in Conjunction with Oxytocin in Reduction of PostPartum Hemorrhage After LSCS: A Prospective Randomized Study

AIM : The aim of this study is to compare the prophylactic efficacy of sublingual misoprostol (800 μg) versus IV tranexamic acid (1gm), each administered in conjunction with oxytocin, in reducing blood loss during LSCS METHOD: Hospital based prospective randomised study over a period of one year. The women undergoing LSCS who met the inclusion criteria were included. Total 182 patients were included and divided into three groups- control group, miso group and TXA group and comparison done by calculating the amount of blood in gauze used (approx.10cc) and the amount in the suction catheter, comparing pre and post-op Hb, and additional uterotonic agent used. RESULTS : Among 3 groups, Group C (oxytocin + TXA) had noticeably less blood loss with a mean of 395.57 ± 143.02, compared to Group A(oxytocin only) with a mean of 502.00 ± 112.17, and Group B(oxytocin + miso) with a mean of 470.49 ± 110.38 which was statistically significant with a p-value of less than 0.001. In Group A, 60.0% needed additional uterotonic agents, whereas In Group B,39.3% needed additional agents,and In Group C, 32.8% needed additional uterotonic agents, but 67.2% didn't. Group A only 16.7% had PPH,In Group B only 9.8% saw PPH, while in Group C only 6.6% of cases had PPH. CONCLUSION : Combining oxytocin with Misoprostol or Tranexamic acid might be more effective in reducing occurrences of PPH than using oxytocin alone.