Comparative study between oxytocin and combination of tranexamic acid and ethamsylate in reducing intra-operative bleeding during emergency and elective cesarean section after 38 weeks of normal pregnancy

Table 2 Cesarean section outcomes and complications

Parameters	Oxytocin group (n = 100)	Tranexamic acid with ethamsylate group (n = 100)	Saline group (n = 100)	P – value
Operative time (minutes)	64.35 ± 18.72	64.6 ± 19.61	64.7 ± 20.32	0.991
Blood Loss (ml) ^a	625.26 ± 144.06	605.34 ± 158.8	669.73 ± 170.69	0.015*
Hemoglobin (gm/dl)
Preoperative	10.81 ± 0.81	10.81 ± 0.81	10.91 ± 0.86	0.515
Post-operative	9.03 ± 1.2	9.03 ± 1.27	9.11 ± 1.32	0.869
Change	-1.78 ± 1.12	-1.77 ± 1.16	-1.79 ± 1.2	0.968
Hematocrit (%)
Preoperative	32.41 ± 2.46	32.41 ± 2.43	32.83 ± 2.65	0.302
Post-operative	26.57 ± 3.96	26.79 ± 4.09	26.56 ± 4.52	0.842
Change	-5.84 ± 3.91	-5.62 ± 3.94	-6.28 ± 4.36	0.361
Hospital stay	2.25 ± 2.06	2.3 ± 2.16	2.16 ± 2.09	0.883
Blood transfusion	14	11	18	0.366
Intra-operative adhesion	30	19	23	0.183
Post-partum Hemorrhage	30	23	36	0.131
Post-operative thrombosis	3	14	0	< 0.0001*
Post-operative fever	26	20	17	0.282
Post-operative wound infection	18	20	18	0.916
Need to hysterectomy	0	0	4	0.017*
Need for other procedures				0.228
Methergine	7	6	11
Oxytocin	11	11	6
Methergine and oxytocin	3	1	7
B-lynch (failed oxytocin and methergine)	4	4	8
Internal iliac ligation	5	2	4
No action	70	76	64

The continuous outcomes were adjusted according to parity, previous CS, CS type, and the indication of CS using the one-way ANCOVA statistical test while the categorical outcomes were analyzed by Chi-square test
^aBlood loss: one-way ANCOVA showed a significant difference between groups. Post hoc (Bonferroni) test showed that oxytocin did not reduce blood loss compared to saline (mean difference =—43.414, P = 0.211), nor to tranexamic acid and ethamsylate (mean difference = 21.499, P = 1). It also showed that tranexamic acid and ethamsylate significantly reduced blood loss compared to saline (mean difference =—64.914, P = 0.013)
^* Significant results P < 0.05

ISSN: 1471-2393