Effect of tranexamic acid in prevention of postpartum hemorrhage in elective caesarean delivery: a randomized controlled study

Abstract

Background: Postpartum hemorrhage is the ugly ghost that most obstetricians believe because many cases unpredicted and may be associated with rapid patient deterioration that may lead mortality or developing serious long-term morbidities. The objective of this study is to assess the efficacy of slowly intravenous administration of tranexamic acid in prevention and decline the severity of postpartum hemorrhage immediately prior to elective caesarean section.Methods: A double blinded, randomized, case control trial carried out at Obstetrics and Gynecology Department, Faculty of Medicine, South Valley University, Egypt from May 2017 to April 2018. This study was conducted on 500 full term pregnant women underwent elective caesarean section. The patients were divided randomly into: Group A (study group) included 250 patients received tranexamic acid 1gm slowly iv over 2 minutes at least 10 minutes before operation started and Group B (control group) included 250 patients that received placebo (normal saline NaCl 0.9%).Results: Incidence of PPH in group A and group B were (4.4% and 6.8) respectively, 1.2% in group A and 2.8% in group B had severe degree of PPH. Amount of blood loss immediately after placental delivery up to first 6 hours postoperative was statistically significant increase in placebo group than tranexamic acid group with p value <0.001.Conclusions: Tranexamic acid administration few minutes prior to elective cesarean section was effective in reducing the incidence and severity of PPH and decreased the use of additional uterotonic drugs and additional surgical interventions.

The Effect of Tranexamic Acid on Reducing the Amount of Blood Loss During Cesarean Section at Maternity Hospital in Duhok

“…the mean hematocrit reduction was less in G1 (2.10% ± 1.55 SD) versus G2 (2.99% ± 2.24 SD). These results were similar to two studies done in Egypt by Abd El-Naser et al 13 and Albaz 14 . Regarding the need for extra uterotonics, less uterotonics were required in G1 (1.5%) versus (4%) in G2.…”

Tranexamic acid to reduce blood loss in women at high risk of postpartum hemorrhage undergoing cesarean delivery—a randomized controlled trial

“…Our results are similar to the findings of an RCT conducted in Egypt among 500 women at low risk of PPH. 15 This is also similar to a study conducted in Chhattisgarh among 100 women randomized to 2 groups undergoing CD who received either TXA or no drug. 16 Both studies found a significant reduction in blood loss when TXA was administered.…”

Effect of preoperative prophylactic intravenous tranexamic acid on perioperative blood loss control in patients undergoing cesarean delivery: a systematic review and meta-analysis

“…20 min before the procedure 10 mL normal saline, IV. 20 min before the procedure 10 IU oxytocin IM + 10 IU oxytocin IV, immediately after delivery Abd El-Naser Abd El-Gaber [ 20 ] 2019 Egypt 500 (250/250) 1 g of TXA, IV. 10 min before skin incision, over 2 min normal saline, IV.…”

“…The quantity of post-operative blood loss (mL) = weight of used drapes—weight of drapes prior to used) × 0.9 Mehmet B. Sentu ¨rk [ 17 ] Blood loss was collected through operation pads and tampons (with 1 g sensitive scale) The quantity of blood loss (mL) = (weight of used materials—weight of materials prior to used)/1.05 Anuradha Ghosh [ 18 ] Blood loss was collected through a suction container, operation sheets, gauze pieces and mops (1 g is equivalent to 1 mL) The quantity of intra-operative blood loss (mL) = (weight of used materials—weight of materials prior to used) + (the volume of blood sucked in suction bottle). The quantity of post-operative blood loss (mL) = weight of used pads—weight of pads prior to used Haitham Torky [ 19 ] Blood loss was collected through towels The quantity of blood loss (mL) = weight of used materials—weight of materials prior to used Abd El-Naser Abd El-Gaber [ 20 ] Blood loss was collected through a suction container, towels, and pads The quantity of intra-operative blood loss (mL) = (weight of used towels—weight of towels prior to used) + (the volume sucked in the suction bottle after placental delivery). The quantity of post-operative blood loss (mL) = weight of used pads—weight of pads prior to used Forozan Milani [ 21 ] Blood loss was collected through a suction container, gauzes, sterile drapes, and pads The quantity of intra-operative blood loss (mL) = (weight of used materials—weight of materials prior to used) + (the volume of blood sucked in suction bottle).…”