Efficacité et sécurité de l’acide tranexamique en prévention et/ou en traitement de l’hémorragie du post-partum : une revue systématique de la littérature avec méta-analyse

Faraoni, David; Carlier, C; Samama, Charles C.M.; Levy, Jerrold J.H.; Ducloy-Bouthors, A.-S.

doi:10.1016/j.annfar.2014.07.748

Cited by 10 publications

(7 citation statements)

References 47 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, their study did not take into account the influence of model of delivery, which might introduce bias. [37] Faraoni et al [47] conducted a meta-analysis with 10 trials that evaluated the efficacy of TA administration in reducing blood loss for women undergoing CS or VD. They concluded that TA administration significantly reduced blood loss and lowered the occurrence rate of PPH regardless of the mode of delivery.…”

Section: Discussionmentioning

confidence: 99%

Is prophylactic tranexamic acid administration effective and safe for postpartum hemorrhage prevention?

Gong

Dong

et al. 2017

Medicine

View full text Add to dashboard Cite

Background:To assess the efficacy and safety of tranexamic acid (TA) in reducing blood loss and lowering transfusion needs for patients undergoing caesarean section (CS) or vaginal delivery (VD).Methods:An electronic literature search of PubMed, EMBASE, OVID, Cochrane library, Scopus, Central, and Clinical trials.gov was performed to identify studies that evaluating the usage of TA in CS or VD. The methodological quality of included trials was assessed and data extraction was performed.Results:Finally, 25 articles with 4747 participants were included. Our findings indicated TA resulted in a reduced intra-, postoperative, and total blood loss by a mean volume of 141.25 mL (95% confidence interval [CI] −186.72 to −95.79, P < 0.00001), 36.42 mL (95% CI −46.50 to −26.34, P < 0.00001), and 154.25 mL (95% CI −182.04 to −126.47, P < 0.00001) in CS. TA administration in VD was associated with a reduced intra-, postoperative, and total blood loss by a mean volume of 22.88 mL (95% CI −50.54 to 4.77, P = 0.10), 41.24 mL (95% CI −55.50 to −26.98, P < 0.00001), and 84.79 mL (95% CI −109.93 to −59.65, P < 0.00001). In addition, TA could lower the occurrence rate of postpartum hemorrhage (PPH) and severe PPH, and reduce the risk of blood transfusions. No increased risk of deep vein thrombosis (DVT) after CS or VD was associated with TA usage, while the minor side effects were more common.Conclusions:Our findings indicated that intravenous TA for patients undergoing CS was effective and safe. Although prophylactic TA administration is associated with reduced PPH, current existing data are insufficient to draw definitive recommendations about its clinical significance due to the poor to moderate quality of the included literatures. Thus, high-quality randomized controlled trials with larger samples are needed to validate our findings.

show abstract

Section: Discussionmentioning

confidence: 99%

Is prophylactic tranexamic acid administration effective and safe for postpartum hemorrhage prevention?

Gong

Dong

et al. 2017

Medicine

View full text Add to dashboard Cite

show abstract

“…Of the 29 systematic reviews, 18 Cochrane systematic reviews and 11 non-Cochrane systematic reviews were analysed: five studies examining active management of the third stage of labour [ 21 , 23 , 47 – 49 ], eight examining the use of oxytocin [ 24 – 29 , 50 , 51 ], seven examining the use of prostaglandin [ 30 – 32 , 52 – 55 ], one examining the use of ergot alkaloids [ 33 ], five examining tranexamic acid [ 56 – 60 ], one examining timing of umbilical cord clamping [ 22 ], one examining uterine massage [ 61 ], and one examining breastfeeding or nipple stimulation [ 62 ]. The participants in these reviews had undergone caesarean or vaginal deliveries.…”

Section: Resultsmentioning

confidence: 99%

“…A total of 20 reviews examining blood loss > 1000 mL were identified: four regarding active management of the third stage of labour [ 21 , 23 , 47 , 48 ], six examining the use of oxytocin [ 24 , 27 – 29 , 50 , 51 ], four examining the use of prostaglandins [ 32 , 52 – 54 ], one examining the use of ergot alkaloids [ 33 ], three examining the use of tranexamic acid [ 56 , 59 , 60 ], one examining the timing of clamping umbilical cord [ 22 ], and one examining uterine massage [ 61 ]. Table 4 only displays interventions that compared the intervention with placebo or contrasting management.…”

Section: Resultsmentioning

confidence: 99%

“…Tranexamic acid significantly reduced the incidence of severe PPH compared to placebo or no treatment (50/882 versus 84/872; RR = 0.49, 95% CI = 0.33 to 0.74; 4 RCTs; 1754 women; heterogeneity; I 2 = 0%) [ 56 ], (16/1051 versus 39/1042; RR = 0.40, 95% CI = 0.23 to 0.71; 6 RCTs; 2093 women; heterogeneity; I 2 = 0%) [ 59 ] and (9/703 versus 21/697; RR = 0.43; 95% CI = 0.20 to 0.94; 2 RCTs; 1400 women; heterogeneity; I 2 = 0%) [ 60 ].…”

Section: Resultsmentioning

confidence: 99%

“…A few effective interventions were identified: active management of the third stage of labour rather than physiological or expectant management [ 21 , 48 ], administration of oxytocin (5–10 IU) [ 29 ], and tranexamic acid versus placebo [ 56 , 59 , 60 ]. A lack of evidence was identified (i.e., no studies found) for the following interventions: fundal pressure versus controlled cord traction as part of the active management of the third stage of labour [ 49 ] and intramuscular versus intravenous oxytocin [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Prophylactic management of postpartum haemorrhage in the third stage of labour: an overview of systematic reviews

et al. 2018

View full text Add to dashboard Cite

BackgroundPostpartum haemorrhage is a direct cause of maternal death worldwide and usually occurs during the third stage of labour. Most women receive some type of prophylactic management, which may include pharmacological or non-pharmacological interventions. The objective of this study was to summarize systematic reviews that assessed the effects of postpartum haemorrhage prophylactic management during the third stage of labour.MethodsWe applied the guidelines for conducting an overview of reviews from the Cochrane Handbook for Systematic Reviews of Interventions. We searched MEDLINE, EMBASE, and the Cochrane Database of Systematic Reviews to identify all relevant systematic reviews of randomized controlled trials of prophylactic management of postpartum haemorrhage in the third stage of labour compared with no treatment, placebo, or another management technique. Two review authors independently extracted data and assessed methodological quality using a measurement tool to assess reviews and quality of evidence using the Grades of Recommendation, Assessment, Development, and Evaluation for primary outcomes, summarizing results narratively.ResultsWe identified 29 systematic reviews: 18 Cochrane and 11 non-Cochrane. Cochrane systematic reviews were high quality, while the quality of non-Cochrane systematic reviews varied. The following techniques suggested effective, third-stage interventions to reduce the incidence of severe postpartum haemorrhage: active management of the third stage of labour compared to physiological management, active management compared to expectant management, administration of oxytocin compared to placebo, and use of tranexamic acid compared to placebo. The following third-stage management approaches reduced the need for blood transfusion: active management compared to physiological management, active management compared to expectant management, oral misoprostol compared to placebo, and tranexamic acid compared to placebo.ConclusionsNo effective prophylactic management techniques were identified for maternal mortality. Most methods of effective prophylactic management of postpartum haemorrhage were supported by evidence; however, they were limited to low- or moderate-quality evidence, and high-quality studies are therefore needed. Outcome measures of the included systematic reviews varied. It is recommended that outcome measures in preventive postpartum haemorrhage intervention trials align with the World Health Organization guidelines.Systematic review registrationPROSPERO: CRD42016049220.Electronic supplementary materialThe online version of this article (10.1186/s13643-018-0817-3) contains supplementary material, which is available to authorized users.

show abstract

The role of tranexamic acid in the management of postpartum haemorrhage

Bouthors

Gilliot

Sentilhes

et al. 2022

Best Practice & Research Clinical Anaesthesiology

View full text Add to dashboard Cite

Efficacité et sécurité de l’acide tranexamique en prévention et/ou en traitement de l’hémorragie du post-partum : une revue systématique de la littérature avec méta-analyse

Cited by 10 publications

References 47 publications

Is prophylactic tranexamic acid administration effective and safe for postpartum hemorrhage prevention?

Is prophylactic tranexamic acid administration effective and safe for postpartum hemorrhage prevention?

Prophylactic management of postpartum haemorrhage in the third stage of labour: an overview of systematic reviews

The role of tranexamic acid in the management of postpartum haemorrhage

Contact Info

Product

Resources

About