The purpose of this study was to evaluate that the tranexamic acid (TXA)Intravenous and oral, is equivalent oxytocin (OXY),intramuscularly, in reducing the blood loss in post partum period (mL) in patients at the end of pregnancy ( 37-42 w ) at low risk of post partum hemorrhage (PPH). The PPH means a blood loss equal to or greater than 500 ml after a vaginal delivery ( the bleeding is defined severe if it exceeds 1000 mL). PPH is called "primary" when blood loss arose within 24 hours after birth. This is a open-trial randomized, longitudinal, controlled that including 486 subjects .
This trial includes three arms of treatment : * arm A (IMP1Test): TXA 500mg/ 2 vials (1 gr) oral within 5 minutes from the delivery (third stage af labor) * arm B (IMP2Test): TXA 500 mg/ 2 vials (1 gr) slow intravenous infusion 1ml/min within 5 minutes from the delivery(third stage af labor) * arm C (control): OXY 5 IU/ml/ 2 vials (10 International Unit) intramuscularly within 5 minutes from the delivery (third stage af labor) The clamping of the umbilical cord will be executed immediately after birth The randomization 1:1:1 (block design), generated by the computer. Primary outcomes: assessment of total blood loss expressed in mL * immediately after delivery * two hours after delivery The measurement of the overall blood loss at delivery (ml) will be performed by the graduated bag, immediately after birth. The measurement two hours after delivery will be performed by weighing of the adsorbent material \[ N.ml = N. gr indicated by the balance - dry weight of the sanitary napkin\]. The overall loss in blood measured (ml) two hours of delivery will then be performed by adding the two collections.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
2 vials ( =1 gram) of Tranexamic Acid oral administered within 5 minutes from the delivery (third stage after labor) 2 vials (=1 gram ) of Tranexamic Acid administered slow intravenous infusion within 5 minutes from the delivery (third stage after labor)
2 vials ( =1 gram) of Tranexamic Acid slow intravenous infusion administered within 5 minutes from the delivery (third stage after labor)
2 vials (=10 IU/International Unit) of oxytocin administered intramuscularly within 5 minutes from the delivery (third stage after labor)
assessment of total blood loss expressed in mL
global blood loss \> 500 mL
Time frame: immediately after delivery
assessment of total blood loss expressed in mL
global blood loss \> 500 mL
Time frame: two hours after delivery
assessment of the number of hemodynamic changes
hypotension (number of women with Arterial Pressure \< 100/60 mm/Hg )
Time frame: immediately after delivery
assessment of the number of hemodynamic changes
hypotension (number of women with Arterial Pressure \< 100/60 mm/Hg )
Time frame: two hours after delivery
assessment of the number of hemodynamic changes
increased heart rate (number of women with Heart Rate \> 60 bpm )
Time frame: immediately after delivery
assessment of the number of hemodynamic changes
increased heart rate (number of women with Heart Rate \> 60 bpm )
Time frame: two hours after delivery
assessment of the need of using additional uterotonic
administration additional drug for the treatment of PPH
Time frame: immediately after delivery
assessment of the need of using additional uterotonic
administration additional drug for the treatment of PPH
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Time frame: two hours after delivery
assessment the need for surgical manoeuvres for the bleeding control
need of intrauterine balloon or uterine compression sutures for surgical treatment of the PPH or hysterectomy
Time frame: immediately after delivery
assessment the need for surgical manoeuvres for the bleeding control
need of intrauterine balloon or uterine compression sutures for surgical treatment of the PPH or hysterectomy
Time frame: two hours after delivery
assessment the need for the blood transfusions
Hb \<7 g/dL
Time frame: two days after delivery