Evidence map›Paper›PMID 37626292›Full record

Trial reportBMC pregnancy and childbirth2023

Intravenous tranexamic acid vs. sublingual misoprostol in high-risk women for postpartum haemorrhage following cesarean delivery; a randomised clinical trial.

Mariam Dawoud, Maha Al-Husseiny, Omneya Helal, Moutaz Elsherbini, Mazen Abdel-Rasheed, Mona Sediek

Retracted Registry-linked trialOpen access · goldAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC pregnancy and childbirth, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It has been retracted, and should not be counted. It is linked to trial NCT04117243 (The Efficacy and Safety of Preoperative Intravenous Tranexamic Acid Versus Sublingual Misoprostol in Reducing Blood Loss During and After Elective Cesarean Section Among High Risk Pregnant Cases.), which is not on this map. Cited by 7 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 6 pooled it
6.4field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04117243 phase2completednot on this map

The Efficacy and Safety of Preoperative Intravenous Tranexamic Acid Versus Sublingual Misoprostol in Reducing Blood Loss During and After Elective Cesarean Section Among High Risk Pregnant Cases.

TypeinterventionalSponsorCairo UniversityRan2020 to 2020Enrolled345ConditionsPost Partum HemorrhageArmsMisoprostol, Tranexamic acid, Oxytocin
3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 6 syntheses or guidelines pooled it, 11 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Tranexamic acid for preventing postpartum haemorrhage after vaginal birth.The Cochrane database of systematic reviews · 2025
    Pooled it
  5. Pooled it
  6. Pooled it
  7. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 1 country.

Mariam DawoudObstetrics and Gynaecology Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
Maha Al-HusseinyObstetrics and Gynaecology Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
Omneya HelalObstetrics and Gynaecology Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
Moutaz ElsherbiniObstetrics and Gynaecology Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
Mazen Abdel-RasheedReproductive Health Research Department, National Research Centre, 33 El-Buhouth St, Dokki, 12622, Cairo, Egypt. doctor_mazen@hotmail.com.ORCID http://orcid.org/0000-0001-5575-1782
Mona SediekObstetrics and Gynaecology Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
Cairo University · EGNational Research Centre · EG

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThis study compares the effectiveness of administering sublingual misoprostol combined with oxytocin to that of IV tranexamic acid combined with oxytocin to reduce intra and post-operative blood loss in high-risk women for postpartum haemorrhage (PPH) following cesarean section (CS).

methodsAbout 315 high-risk pregnant women undergoing CS participated in this trial. They were randomly assigned into three groups; tranexamic group, misoprostol group, and control group, according to the medication given in the operative theatre. All patients received oxytocin intraoperatively. They were assessed regarding intraoperative blood loss, the incidence of PPH, and the reduction in haemoglobin and hematocrit values.

resultsBoth tranexamic and misoprostol groups had similar results in reducing intra and post-operative blood loss. However, the reduction in haemoglobin and hematocrit were significantly lower in tranexamic and misoprostol groups compared to the control group (-0.78 ± 0.57 vs. -0.83 ± 0.52 vs. -1.32 ± 0.57 gm/dl, P < 0.001 and - 3.05 ± 1.28 vs. -3.06 ± 1.13 vs. -4.94 ± 1.82%, P < 0.001 respectively). In addition, the estimated blood loss was significantly lower in the tranexamic and misoprostol groups compared to the control group (641.6 ± 271.9 vs. 617.9 ± 207.4 vs. 1002.4 ± 340.7 ml, P < 0.001).

conclusionBoth tranexamic acid and misoprostol are equally capable of reducing blood loss, but the results were significantly better compared to using oxytocin alone in high-risk patients. CLINICAL

trial registrationRegistered at www. CLINICALTRIALS: govon07/10/2019 with registration number NCT04117243.

Indexed as

MisoprostolPostpartum HemorrhageTranexamic AcidBlood Loss, SurgicalCesarean SectionFemaleHumansOxytocinPostoperative HemorrhagePregnancyMisoprostolOxytocinTranexamic AcidMisoprostolOxytocinPostpartum haemorrhageTranexamic acid

Identifiers

PMID37626292
PMCPMC10463445
OpenAlexW4386165551

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.