Intravenous vitamin C for bleeding control in elective C-sections: a randomized clinical trial study

Objective: This study aimed to evaluate whether intravenous vitamin C reduces intraoperative and postoperative blood loss in elective cesarean deliveries, with primary outcomes focusing on hemoglobin preservation and quantified blood loss measurements. Methods: In this randomized trial, 60 women undergoing elective morning cesarean sections (CS) were assigned to receive either 1 g Intravenous (IV) vitamin C (n = 30) or placebo (n = 30) 2 hours preoperatively. The primary endpoint was the change in hemoglobin level from preoperative baseline to 24 hours postoperative. Secondary outcomes included quantified blood loss (suction volume, weighed gauze/sponges), uterotonic requirements, and procedure duration. Results: Baseline characteristics showed no significant differences between groups. The vitamin C intervention group demonstrated superior outcomes across multiple measures: intraoperative gauze use was reduced by 30% (4.43 ± 1.04 vs 6.37 ± 1.29, P < 0.001), sponge use decreased by 31% (1.13 ± 0.34 vs 1.63 ± 0.49, P < 0.001), and suction volume was 13% lower (522 ± 54cc vs 598 ± 68cc, P < 0.001). Clinically meaningful benefits included 31% fewer uterotonic requirements ( P = 0.003), significantly better hemoglobin preservation (0.07 vs 1.38 g/dL, P < 0.001), and reduced surgical duration ( P < 0.001). Postoperative pad usage showed no significant difference between groups ( P = 0.344). These findings collectively demonstrate vitamin C controls intraoperative blood loss while maintaining patient stability. Conclusion: Prophylactic vitamin C significantly reduces intraoperative blood loss and preserves hemoglobin during elective CS, while shortening procedure time and decreasing uterotonic needs. These clinically meaningful benefits support its use as a safe adjuvant therapy.