Objectives To assess the effect of intravenous versus topical tranexamic acid in reducing intraoperative and postoperative blood loss in women with abdominal hysterectomy.
Materials and MethodsThe study was a randomized double-blind placebo-controlled trial, carried out in a tertiary university hospital in Egypt, from November 2015 to October 2017. A total of 129 women undergoing abdominal hysterectomy for benign etiology were randomly assigned to three groups: Group I [43 patients received 110 ml normal saline IV just before skin in scion], Group II [43 patients received 1 g tranexamic acid in 100 ml saline IV just before skin in scion], and Group III [43 patients received 2 g topical tranexamic acid applied intra-abdominal after hysterectomy]. The primary outcome was intraoperative, postoperative, and all blood loss estimation. Results Both Group II (IV tranexamic acid) and Group III (topical tranexamic acid application) showed great reduction in intraoperative and postoperative blood loss (blood in the intra-abdominal drain) compared with Group I (placebo group), (P = 0.0001, 0.0001, 0.0001, 0.0001), so the overall estimated blood loss in groups II and III showed highly reduction compared with Group I (P = 0.0001, 0.0001). Conclusion Intravenous and topical tranexamic acid application is a safe and reliable method to help decrease blood loss during and after abdominal hysterectomy.
In settings like rural area or home delivery in which oxytocin is not available, alternative oral TA plus buccal misoprostol may be considered as an effective line in prevention of PPH.
Results: There were no significant differences between groups with regard to the basic criteria. The exercise program decreased the incidence of preeclampsia (OR=0.120; p=0.037), postdate (OR=0.274; p=0.008), excessive weight gain (OR=0.220; p=0.000), and cesarean delivery (OR=0.519; p=0.007).
Conclusion:Regular maternal walking throughout the pregnancy may be a preventive tool for preeclampsia, postdate pregnancy, excessive weight gain and may decrease the incidence of cesarean delivery in primigravidas.
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