Tranexamic Acid and Ethamsylate For Preventing PPH in Patient Undergoing LSCS at High Risk For PPH

Inclusion Criteria: 1. Women undergoing elective caesarean section 2. Patient having one or more risk factor for PPH * Multiple pregnancy * Polyhydramnios (AFI \>25cm) * Macrocosmic baby (\>4.5 Kg) * Prolonged , augmented and obstructed labour * Obese patients(BMI \>30) * Premature rapture of membranes * Previous history of PPH 3. Age ≥18 years 4. Gestational Age ≥ 35 Weeks 5. Informed Oral Consent From The Patient Exclusion Criteria: 1. History of venous thrombosis (DVT and/or Pulmonary embolism) OR arterial thrombosis (angina pectoris , myocardial infarction, stroke) 2. History of epilepsy or seizure 3. Any Known Cardiovascular , renal or liver Disease 4. Autoimmune Diseases 5. Sickle Cell Disease 6. Severe hemorrhagic Disease 7. Placenta Previa. 8. Morbidly adherent Placenta 9. Abruptio placenta 10. Eclampsia, hemolysis, elevated liver enzymes, and low platelet count syndrome 11. Administration Of low molecular weight heparin or Anti platelets the week before delivery .