RESUMO
Background: The achievement of safe child birth by caesarean delivery (CD) was one of the greatest medical advances of the 20th century. Indeed, CD is now the most frequent operation performed, consulting approximately one third of all deliveries annually. Aim: To evaluate the effect of preoperative administration of Injection tranexamic acid on blood loss during and 2 hrs after elective caesarean delivery. Materials and methods: This study was a prospective observational study for a period of 15 months; randomized controlled trial was conducted among 200 women scheduled for elective Cesarean delivery. Results: A comparative study was undertaken to study the effect of inj. TXA on blood loss during and after Cesarean delivery. The mean age in tranexamic group was 23.40±3.06 while in control group was 23.59±3.56. 64% fall in age group 21-25 years. In Gravida Distribution, majority of the patients in both the groups are of Gravida 2 (Group A 65% and Group B 64%). The mean ± SD was 2.17 ± 0.65 in study group and 2.2 ± 0.56 in control group. Comparison of blood loss between two groups, intra-operative blood loss was lower in the study group than in the control group 375±69 vs 410±79.9 and is statistically significant. The mean postpartum blood loss was also in the study group than in the control group 52±30 Vs 131±42 and was statistically significant. Conclusion: Tranexamic acid injection significantly reduces the perioperative blood elective Cesarean section, if given prior to the skin incision, without significant adverse effects.
RESUMO
Background: In India, 65% of women in the first year of post-partum period have an unmet need for family planning. Hence contraception needs to be practiced in this critical period. Aim: The present study was planned to evaluate the efficacy, safety, and compliance of intra Cesarean IUD insertions. Materials and methods: This was a prospective study for 3 years. Women recruited had CuT-380A insertion immediately after delivery of the placenta during Elective /Emergency Cesarean section. Women having unresolved post-partum hemorrhage (PPH), pre-labor rupture of membranes of (PROM) >18 hrs, fever >38 ˚C, congenital uterine malformation and fibroid uterus distorting the cavity were excluded from the study. The women were followed up with 3 visits at 4- 6 weeks, 3 months and 1 year. Results: Total women counseled were 4141, accepted no was 2850, declined no was 1291, consented but not inserted in 109 as criteria was not met. Lost to follow up 46, followed up 2850, complications (Expulsion 6, IUCD in situ with pregnancy 1, Bleeding 33, String problem 363, Removal 28, Continuation 2745). Conclusion: Immediate post –placental IUCD insertion provides highly effective contraception to the woman at the time of discharge itself. The government needs to develop strategies to increase public awareness of the PPIUCD through different media sources.