Blood Loss During Cesarean Delivery in Placenta Previa Patients

Inclusion Criteria: * Parity: primigravida or multigravida. * Gestational age: ≥ 36 weeks (confirmed by the first day of the last menstrual period or first trimester ultrasound scan). * Candidate for termination of pregnancy by cesarean delivery. * Singleton living healthy normally growing fetus. * Cesarean delivery under spinal anesthesia. * Pregnancies complicated with placenta previa diagnosed preoperatively by ultrasonography (placenta previa was defined as placenta partially or totally covers the cervix) Exclusion Criteria: * Patients diagnosed with morbidly adherent placenta. * Placenta previa cases requiring cesarean hysterectomy in the primary surgery. * Patients with preoperative anemia (Hemoglobin \<9 gm/dl). * History of thromboembolic event. * Known allergy to tranexamic acid or prostaglandins. * Bronchial asthma or other contraindications of misoprostol. * Patients with other risk factors of postpartum hemorrhage (e.g., polyhydramnios, fetal macrosomia, uterine fibroid). * Patients known to have bleeding tendency (e.g., those receiving anticoagulation, patients with thrombocytopenia, factor VIII or IX deficiency or Von Willebrand's disease). * More than 2 previous cesarean deliveries procedures. * Prolonged procedure (more than 2 hours from skin incision to skin closure). * Concomitant maternal medical disorders (either chronic or pregnancy induced)