الفهرس 
PLACENTA PREVIAOnly 14 pages are availabe for public view
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Abstract
Background: patients with placenta previa are at risk for intra- and postpartum massive blood loss as well as increased risk of placenta accreta, a type of abnormal placental implantation. This condition can lead to serious obstetric complications, including maternal mortality and morbidity. The risk factors for previa include prior cesarean section, multiparity, advanced maternal age, prior placenta previa history, prior uterine surgery, and smoking. The prevalence of previa parturients has increased due to the rising rates of cesarean section and advanced maternal age.
Aim of the Work: to evaluate the efficacy of local tranexamic acid in controlling of placental bed bleeding in cases with placenta Previa.
Patients and Methods: this randomized controlled study was conducted on 60 pregnant women with placenta Previa attending Ain Shams University Maternity Hospital for delivery. Patients randomly divided into two equal groups: group (I): 30 patients received topical tranexamic acid after IV oxytocin and group (II): 30 patients received placebo after IV oxytocin.
Results: The mean age was 28.03±4.02 years and 28.87± 6.0 years in study group and control group respectively. There was no statistically significant difference regarding age between the two studied groups. The mean intraoperative volume of the contents of the suction bottle in study group was 427.59± 165.61 ml while it was 455.17± 216.44 ml in control group. No statistically significant differences were observed between the two studied groups regarding intraoperative volume of the contents of the suction bottle. The mean difference in weight between dry and soaked sheets and towels in study group was 588.6± 197.39 ml while it was 791.67± 343.23 ml in control group. The difference in weight between dry and soaked sheets and towels was significantly lower in study group compared to control group.
Conclusion: based on the previous findings, it is apparent that topical administration of TXA is associated with decreased blood loss, lesser need for blood transfusion and less change in hematological parameters compared to its placebo but without statistical significance. Tranexamic acid infusion was effective in reducing intraoperative blood loss and intraoperative and postoperative blood and blood products’ transfusion.