Tranexamic acid versus Misoprostol in reducing blood loss during cesarean section: a cross-sectional comparative study in Abakaliki, Nigeria

The maternal demographic and obstetrics factors and blood loss determinants like bedside clotting time, duration of surgery and cadre of surgeon during cesarean section were statistically non-significant between the two groups. Mean intraoperative blood loss was not significantly different between the misoprostol group and tranexamic acid group (547 ± 183.75ml vs. 551.66 ± 21.74ml, P = 0.519). The mean difference in PCV changes was not significant between the groups (2.41±0.95% vs. 2.29±0.56%, P = 0.463). Side effect profile was similar for both groups except shivering which was statistically higher among the misoprostol group compared to the tranexamic acid group (RR = 0.70; 95%CI 0.40 - 0.91, P = 0.028). From this study, tranexamic acid was comparable to misoprostol in the reduction of blood loss during cesarean section. Therefore, tranexamic acid could act as a good alternative to misoprostol for prophylaxis for blood loss during elective cesarean section.