Purpose to evaluate the effects of topical tranexamic acid (TA) on reducing post-partum hemorrhage in pregnant women with hemorrhagic cesarean section

Uterine atony is the major cause of postpartum hemorrhage (PPH), accounting for up to 80% of PPH cases. PPH is the leading cause of maternal morbidity and mortality worldwide, resulting in up to 28% of maternal deaths. Therefore, inducing a rapid and effective uterine contraction following delivery is an important issue. The aim of the study is to To explore the efficacy and safety of temporary uterine packing combined with topical tranexamic acid (TA) as an adjunct for reducing blood loss during a hemorrhagic cesarean delivery (CD), compared with placebo.

Inclusion Criteria:

• patients who were admitted for an elective or non-emergency CS during labor and exposed to intraoperative bleeding about 800 ml

Exclusion Criteria:

• placenta praevia and placental abruption

• Women with a medical disorder,

• placenta accrete,

• allergy to TA, and

• intraoperative bleeding thanks to causes aside from uterine atony

• Patients over 40 or who have

  • pre-existing coagulation disorders,

• with a severe medical disorder

• allergy to tranexamic acid

• refuse to consent

patients who were admitted for an elective or non-emergency CS during labor and exposed to intraoperative bleeding about 800 ml

open label Randomized Clinical Tria