Postpartum Hemorrhage (PPH): Defined in this study as blood loss of 500 mL or more following a vaginal delivery. Postpartum Blood Loss: Specifically, the quantification of total blood loss within the first 24 hours after childbirth. Uterine Atony: The failure of the uterus to contract sufficiently after delivery, which is the leading cause of postpartum hemorrhage. Postpartum Hemorrhage, Misoprostol , Tranexamic Acid, Oxytocin, Vaginal Delivery, Uterotonic Agents , Uterine Atony , Third Stage
Conditions
Interventions
Participants received 600 micrograms of misoprostol administered sublingually immediately after neonatal delivery and cord clamping, in addition to the standard prophylactic dose of 10 international u
Misoprostol group,Tranexamic Acid group,Oxytocin group
Sponsors
Department of Obstetrics and Gynecology, Buddhachinaraj Phitsanulok Hospital, Phitsanulok, Thailand.
Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University.
Eligibility
Sex/Gender
Female
Age
18 Years to 45 Years
Inclusion criteria
Inclusion criteria: 1. Maternal age between 18 and 45 years 2. Term singleton pregnancy with gestational age of at least 37 weeks 3. Cephalic presentation 4.Planned vaginal delivery 5. For women on antenatal aspirin prophylaxis, discontinuation of aspirin for more than seven days prior to delivery
Exclusion criteria
Exclusion criteria: 1. Known contraindications or hypersensitivity to any of the study medications (misoprostol, tranexamic acid, or oxytocin) 2. Coagulopathy with an INR greater than 1.5 3. Concurrent use of other antiplatelet or anticoagulant agents 4. Preeclampsia with severe feature 5. Antepartum hemorrhage 6. Hepatic or renal impairment 7. A history of thromboembolic disease 8. Inability to provide informed consent 9. Intrapartum event requiring unplanned cesarean delivery, such as cephalopelvic disproportion or non-reassuring fetal status
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Total Quantitative Blood Loss within 24 hours postpartum a calibrated under-buttocks drape for direct volume collection combined with gravimetric method (weighing all blood-soaked materials, where 1 gram equals 1 milliliter) | — |
Secondary
| Measure | Time frame |
|---|---|
| Postpartum Hemorrhage within 24 hours postpartum Incidence,Additional Uterotonic Medications within 24 hours postpartum Incidence ,Uterine Atony within 24 hours postpartum Incidence ,Adverse events within 24 hours postpartum Incidence | — |
Countries
Thailand
Contacts
Public ContactKanchapan Sukonpan
Buddhachinaraj Phitsanulok Hospital
Outcome results
None listed