Participants receive a low dose of Tranexamic acid (10mg/kg) administered slowly over 5 minutes intravenously (iv) 10 minutes prior to skin incision in elective caesarean section with prophylactic oxytocin (5 IU iv) slow administration on delivery of the baby.

Participants receive prophylactic oxytocin (5 IU iv) slow administration on delivery of the baby

Post Partum Hemorrhage

TXA (10mg/kg) solution for injection from the vial will be diluted with 100 - 200ml electrolyte solution such as Normal Saline, Ringers solution, dextrose/water for injection on the same day it is to be used (i.e. when anaesthetist notes the patient has been randomized to receive TXA). Intravenous administration should be at a rate of 100mg or fraction thereof over at least 1 minute - usually at least 5 minutes. Standard practice is to administer over 20 minutes. Administration is to be done at least 10 minutes prior to skin incision.

Tranexamic Acid

5IU of oxytocin are administered intravenously slowly once the baby has been delivered at caesarean section.

Oxytocin

Harare Central Hospital

Parirenyatwa Group of Hospitals

Efficacy of Tranexamic Acid in Preventing Postpartum Haemorrhage After Elective Caesarean Section

Blood loss equal to or exceeding 1000ml following elective caesarean section

Blood loss during caesarean section based on visual estimation and calculation.

Requirement by participant of blood transfusion

Use of additional uterotonics such as an oxytocin infusion or prostaglandin use

Any adverse effects related to tranexamic acid use

Incidence of emergency surgical procedures to manage any postpartum haemorrhage that occurs

Duration of participants' stay in hospital

Apgar scores out of 10 at 1 minute and 5 minute

Reason for and number of days from admission to and duration of stay in neonatal unit

It is undecided whether the IPD will be made available to other researchers. Clearance is required first from ethical bodies and supervisors

Chipo Gwanzura, MD

Junior Registrar

University of Zimbabwe

Randomized control trial with two arms. Participants receive either 10mg/kg of TXA 10 minutes prior to elective caesarean section with prophylactic oxytocin administration after delivery of the baby, versus prophylactic oxytocin alone after delivery of the baby.

Trial is an open label randomized control trial

No intervention mothers will recieve standard maternal and child care education

Peer counseling intervention group will recieve nutrition education on initiation of breastfeeding within one hour of delivery, continuation of exclusive breastfeeding until six months, and timely introduction of safe, nutritionally adequate complementary feeding after six months.

Infant Malnutrition

Pregnant Women

Lactating Mother

Breastfeeding

Infant Nutrition

Stunting

Peer counseling on infant feeding

Mirpur

Peer Conselling Infant Feeding Education Program

Peer Counselling to Improve Feeding Practices and Reduce Malnutrition in Children 0-2 Years in Bangladesh

We expect children in the intervention group (mothers getting counselling on breastfeeding and complementary feeding) will attain a better linear growth compare to control group (not receiving counselling).

Secondary objectives
The percentage of women exclusively breastfeeding (breast milk and no other foods or milk based liquids) their infants at 3 and 6 months will be increased, in the peer counselling group, compared with mothers without the intervention.
The percentage of children consuming foods from >4 food groups at 9, 12, 15 and 18 months will be increased, in peer counselling group, compared with mothers without the intervention.

eclampsia/biegunka

Efficacy of Tranexamic Acid in Preventing Postpartum Haemorrhage After Elective Caesarean Section

Peer Conselling Infant Feeding Education Program

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