['postpartum hemorrhage']
['tranexamic acid and ethamsylate']

        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 .
      