Prophylactic Regimen of Intravenous Oxytocin, Intravenous Tranexamic Acid, and Intramuscular Ergot Derivative for Primary Prevention of Postpartum Hemorrhage in Intrapartum Cesarean Section Versus Intravenous Carbetocin Alone

Prophylactic Regimen of Intravenous Oxytocin, Intravenous Tranexamic Acid, and Intramuscular Ergot Derivative for Primary Prevention of Postpartum Hemorrhage in Intrapartum Cesarean Section Versus Intravenous Carbetocin Alone

While Carbetocin is effective in reducing PPH, the combination of oxytocin, Tranexamic acid, and Ergot derivatives may offer additional benefits in high-risk populations. We hypothesize that the combination regimen will reduce PPH incidence and severity compared to Carbetocin alone and may be more cost effective

Inclusion Criteria:

• Women undergoing C-Sections.
• Women between the ages of 18 and 45 years.
• Singleton pregnancy.
• Gestational age is equal to or more than 36 weeks.
• No known coagulopathy or bleeding disorders.
• No known hypersensitivity or allergy to drugs used in the study.
• Normal obstetric ultrasonography with no fetal abnormalities.

Exclusion Criteria:

• Hemodynamically unstable or immobile patients.
• Multifetal pregnancy.
• Patients who are receiving prophylactic or therapeutic anticoagulation.
• Known comorbidities and contraindications to the use of Ergot derivatives or Carbetocin such as hypertension or cardiovascular disorders.
• Placenta previa and/or Placenta accreta spectrum.
• History of thromboembolism.
• Preeclampsia or eclampsia.
• Any additional measurements needed to control or stop excessive bleeding intraoperatively such as uterine artery ligation or use of sterile gelatin absorbable foam.