Carbetocin Versus Oral Tranexamic Acid Plus, Buccal Misoprostol on Blood Loss After Vaginal Delivery
Status:
Completed
Trial end date:
2020-07-01
Target enrollment:
Participant gender:
Summary
Excessive bleeding at or after childbirth accounts for about half of all the post-partum
maternal deaths in developing countries and is the single most important cause of maternal
mortality worldwide. Post-partum hemorrhage (PPH) is the major contributor to maternal
mortality worldwide representing at least 25% of the maternal deaths annually. Prevention of
PPH has become a global aim to reduce maternal mortality. Uterine atony is the main cause of
PPH; therefore, active management of the third stage of labor has emerged as a most actual
tool in its prevention. The previous study in Egypt recorded that 88% of deaths from PPH
occur within 4 hours of delivery. Tranexamic acid (TA) is an antifibrinolytic agent that
blocks the lysine-binding site of plasminogen to fibrin. Misoprostol is effective when given
orally, buccal, sublingually, vaginally, or rectally, so it might be used by traditional
birth attendants, or self-administered, in cases of home-births occurred without the
attendance of health personnel or where women are at most risk for occurrence of severe PPH.
So, the current study aims to evaluate the effect of prophylactic oral TA plus buccal
misoprostol in the prevention of primary PPH after routine active management of the third
stage of labor in women at low risk for uterine atony in comparison with carbetocin and
buccal misoprostol alone.