{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T02:36:48Z","timestamp":1790303808292,"version":"4.1.0"},"reference-count":16,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2023,10,20]],"date-time":"2023-10-20T00:00:00Z","timestamp":1697760000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,10,20]],"date-time":"2023-10-20T00:00:00Z","timestamp":1697760000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100002386","name":"Cairo University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100002386","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Med Res"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>This study aims to illustrate the impact of applying the tranexamic acid impregnated in a gelatin sponge between the anterior rectus sheath and the Rectus Abdominis muscle during Cesarean section (CS) in minimizing rectus sheath hematoma (RHS) in women treated with Warfarin.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>A clinical trial was carried out on 63 pregnant women attended for elective CS, who on antenatal warfarin anticoagulation started from 13\u00a0weeks gestation to 36\u00a0weeks then shifted to low-molecular-weight heparin (LMWH) or unfractionated heparin (UFH), and with an indication for postnatal warfarin anticoagulation. They were randomly assigned on the day of the scheduled CS into three equal groups (21 women for each). Group 1 had two pieces of gelatin sponges soaked with one ampoule of tranexamic acid. Group 2 had two pieces of gelatin sponges not soaked with tranexamic acid. Group 3 (control group) had no gelatin sponge applied. All patients underwent postoperative assessment done for hemoglobin (Hb), hematocrit (HCT), estimated blood loss (EBL), amount and nature of discharge collected from the sub-rectus drain, complications (RHS, wound infection, thromboembolism), need for re-operation, and need for blood transfusion.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Statistically significant differences were found between Group 1 and Group 2 regarding the postoperative Hb (10.66\u2009\u00b1\u20091.13 vs. 9.77\u2009\u00b1\u20090.69, <jats:italic>P<\/jats:italic>\u2009=\u20090.009), between Group 1 and Group 2 regarding the postoperative HCT (31.87\u2009\u00b1\u20093.59 vs. 28.54\u2009\u00b1\u20091.85, <jats:italic>P<\/jats:italic>\u2009=\u20090.001), between Group 1 and Group 2 regarding EBL (442.19\u2009\u00b1\u2009244.46 vs. 744.38\u2009\u00b1\u2009267.05, <jats:italic>P<\/jats:italic>\u2009=\u20090.003), between Group 1 and Group 3 regarding EBL (442.19\u2009\u00b1\u2009244.46 vs. 664.29\u2009\u00b1\u2009343.97, <jats:italic>P<\/jats:italic>\u2009=\u20090.040), and between Group 1 and Group 3 regarding the discharge amount from the sub rectus drain (190.48\u2009\u00b1\u2009100.77 vs. 307.14\u2009\u00b1\u2009127.76, <jats:italic>P<\/jats:italic>\u2009=\u20090.004).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Tranexamic acid-soaked gelatin sponges are safe and effective in reducing postoperative drainage and EBL.<\/jats:p>\n                <jats:p><jats:italic>Clinical Trial Registration<\/jats:italic>: At ClinicalTrials.gov in June 2022 (NCT05439694).<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s40001-023-01434-7","type":"journal-article","created":{"date-parts":[[2023,10,20]],"date-time":"2023-10-20T04:02:15Z","timestamp":1697774535000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Role of tranexamic acid-soaked gelatin sponge in minimizing rectus sheath hematoma after cesarean section in women treated with warfarin, a simple tool for high-risk cases, a randomized controlled trial"],"prefix":"10.1186","volume":"28","clinical-trial-number":[{"clinical-trial-number":"nct05439694","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Ayman","family":"Hany","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayman","family":"Mansour","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mona","family":"Sediek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"Nabil","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,10,20]]},"reference":[{"key":"1434_CR1","doi-asserted-by":"publisher","first-page":"331","DOI":"10.1016\/j.ajog.2012.02.026","volume":"206","author":"L Gibbons","year":"2012","unstructured":"Gibbons L, Belizan JM, Lauer JA, Betran AP, Merialdi M, Althabe F. 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Abdominal compartment syndrome\u2014a fatal complication from a rectus sheath haematoma. Case Re. 2012;2012:bcr1220115332.","journal-title":"Case Re"},{"key":"1434_CR5","doi-asserted-by":"publisher","first-page":"275","DOI":"10.1177\/1358863X08094767","volume":"13","author":"O Osinbowale","year":"2008","unstructured":"Osinbowale O, Bartholomew JR. Rectus sheath hematoma. Vasc Med Lond Engl. 2008;13:275\u20139.","journal-title":"Vasc Med Lond Engl"},{"key":"1434_CR6","volume-title":"Rectus Sheath Hematoma. In: StatPearls","author":"M Allen","year":"2022","unstructured":"Allen M, Sevensma KE. Rectus Sheath Hematoma. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2022."},{"key":"1434_CR7","doi-asserted-by":"publisher","first-page":"585","DOI":"10.2165\/11209070-000000000-00000","volume":"72","author":"PL McCormack","year":"2012","unstructured":"McCormack PL. Tranexamic acid: a review of its use in the treatment of hyperfibrinolysis. 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All methods were carried out following relevant guidelines and regulations. All participants gave their consent after being informed of the study\u2019s objective and design, and they were given the option to leave the study at any time.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Informed consent was obtained from all participants.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"None of the authors has financial or other competing interest.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"448"}}