Thesis (M.Sc.)-Cairo University,2022.

Bibliography: p. 108-99.

Objective: To compare the efficacy and safety profile of IV TA versus intrauterine misoprostol in reducing the blood loss during and after CD in pregnant women diagnosed with placenta previa Methods:A randomized controlled study was undertaken on pregnant women with placenta previa undergoing elective or emergency lower-segment CD. Patients were randomly assigned into one of three groups to receive either 1 g TA (TA group) or 400 microgram intrauterine misoprostol (misoprostol group) or IV oxytocin (oxytocin group / control group). Mean blood loss was calculated and compared among the three groups. Results: Analyses included 27 women in each group. The misoprostol and TA group showed statistically significant lower mean blood loss when compared to the oxytocin group (P <0.001, P = 0.002 respectively). On the other hand, the results were comparable between TA and misoprostol groups (P=0.5). Three cases developed postoperative shivering and mild pyrexia in the misoprostol group and none in the TA group. No neonatal side effects were detected Conclusions:The intrauterine misoprostol or IV TA when added to oxytocin reduces the intra and postoperative blood loss with the same efficacy and safety during CD in patients with placenta previa. Moreover, they showed better efficacy than IV oxytocin alone without significant maternal and neonatal side effects.