The RCOG guideline recommends the use of intravenous oxytocin to reduce the risk of PPH at the time of Caesarean Section. In women at increased risk of PPH, what else should be used to reduce the risk of bleeding?
A. Intramuscular Ergometrine
B. Intramuscular Oxytocin
C. Intramuscular Carbetocin
D. Intravenous Tranexamic acid
E. Intramuscular Syntometrine( Oxytocin+ergometrine)

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The RCOG guideline recommends the use of intravenous oxytocin to reduce the risk of PPH at the time of Caesarean Section. In women at increased risk of PPH, what else should be used to reduce the risk of bleeding?

A. Intramuscular Carbetocin

B. Intravenous Tranexamic acid

C. Intramuscular Ergometrine

D. Intramuscular Oxytocin

E. Intramuscular Syntometrine

• Clinicians should consider the use of intravenous tranexamic acid (0.5–1.0 g), in addition to oxytocin, at caesarean section to reduce blood loss in women at increased risk of PPH.
• Consideration should be given to the use of tranexamic acid in the management of PPH.
• According to a Cochrane review- blood loss greater than 400 or 500 ml was less
  common in women who received tranexamic acid in addition to the usual uterotonic agent after vaginal
  birth or caesarean section in a dosage of 1 or 0.5 g intravenously. Tranexamic acid was effective in
  decreasing the incidence of blood loss greater than 1000 ml in women who had undergone caesarean section but not vaginal birth. Further studies are required to investigate the risk of serious adverse effects, including thromboembolic events.

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