Intravenous vitamin C for bleeding control in elective C-sections: a randomized clinical trial study.

OBJECTIVE

This study aimed to evaluate whether intravenous vitamin C reduces intraoperative and postoperative blood loss in elective cesarean deliveries, with primary outcomes focusing on hemoglobin preservation and quantified blood loss measurements.

METHODS

In this randomized trial, 60 women undergoing elective morning cesarean sections (CS) were assigned to receive either 1 g Intravenous (IV) vitamin C (n = 30) or placebo (n = 30) 2 hours preoperatively. The primary endpoint was the change in hemoglobin level from preoperative baseline to 24 hours postoperative. Secondary outcomes included quantified blood loss (suction volume, weighed gauze/sponges), uterotonic requirements, and procedure duration.

RESULTS

Baseline characteristics showed no significant differences between groups. The vitamin C intervention group demonstrated superior outcomes across multiple measures: intraoperative gauze use was reduced by 30% (4.43 ± 1.04 vs 6.37 ± 1.29, P < 0.001), sponge use decreased by 31% (1.13 ± 0.34 vs 1.63 ± 0.49, P < 0.001), and suction volume was 13% lower (522 ± 54cc vs 598 ± 68cc, P < 0.001). Clinically meaningful benefits included 31% fewer uterotonic requirements (P = 0.003), significantly better hemoglobin preservation (0.07 vs 1.38 g/dL, P < 0.001), and reduced surgical duration (P < 0.001). Postoperative pad usage showed no significant difference between groups (P = 0.344). These findings collectively demonstrate vitamin C controls intraoperative blood loss while maintaining patient stability.

CONCLUSION

Prophylactic vitamin C significantly reduces intraoperative blood loss and preserves hemoglobin during elective CS, while shortening procedure time and decreasing uterotonic needs. These clinically meaningful benefits support its use as a safe adjuvant therapy.