Efficacy of Tranexamic Acid in Decreasing Blood Loss During and After Caesarean Section: A Randomized Case Control Prospective Study

Abstract

To reduce maternal mortality and morbidity caused by bleeding, it is important to reduce the amount of bleeding during and after lower segment caesarean section (LSCS). Tranexamic acid helps to reduce bleeding during and after LSCS. OBJECTIVES: To study the efficacy and safety of Tranexamic acid in reducing blood loss during and after Lower segment Caesarean Section (LSCS). METHODS: A randomized case controlled prospective study was conducted on 200 women undergoing lower segment cesarean section. Hundreds of them that were given tranexamic acid immediately before LSCS were compared to hundred others to whom tranexamic acid was not given. Blood loss was collected and measured during the two periods, from plancental delivery to end of LSCS and second from end of LSCS to two hours postpartum. RESULTS: Tranexamic acid significantly reduced the quantity of blood loss from placental delivery to end of LSCS, 202.25ml in the study group vs392.20 ml in the control group (p<0.001); from the end of LSCS, to 2 hours postpartum 3.80ml in the study group versus 112.25ml in the control group (p<0.001); In totality, it significantly reduced the quantity of blood loss from placental delivery to two hours postpartum i.e. 27.05ml in the study group versus 510.45ml in the control group (p < 0.001). No complications or side effects were noted. CONCLUSION: Tranexamic acid significantly reduced the amount of blood loss during and after LSCS. Tranexamic acid can be used prophylactically; moreover it is safer and effective in women undergoing LSCS.

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

“…However, they were well designed and well implemented. Eighteen trials [10–12,14,15,17–19,21–24,28–31,33,34] provided detailed randomization techniques using a computer-generated randomization list, consecutively numbered sealed opaque envelopes or rand list software, while 7 trials [16,20,25–27,31,32] referred to randomization only without describing the detailed method. Eleven trials [10,11,13,16,21,23,25,31,32] had unclear bias in the allocation concealment while only 1 study [12] presented a higher bias.…”

“…Eleven trials [10,11,13,16,21,23,25,31,32] had unclear bias in the allocation concealment while only 1 study [12] presented a higher bias. For the blinding of participants and personnel, there was a higher bias in 7 studies [10–12,17,20,23,32] due to a lack of information and 6 studies [13,21,25–27,31] had an unclear bias in the blinding measurement. Two studies [19,20] had an unclear bias due to incomplete outcome data reported, and no studies had selective outcome reporting.…”

“…A total of 614 trials [10,11,13,15,17–19,22–25,27,28,31] and 2 trials [32,34] provided detailed data on the effect of TA on the intraoperative blood loss (from fetus delivery to placental delivery) in CS and VD, respectively. Our results indicated that TA administration in CS resulted in a reduced blood loss by a mean volume of 141.25 mL (95% CI −186.72 to −95.79; I 2  = 99%) and a reduced blood loss by a mean volume of 22.88 mL (95% CI −50.54 to 4.77; I 2  = 0%) in VD as compared to control group.…”

“…[39,40] Thus, it is important to evaluate the efficacy and safety of TA on blood loss based on the mode of delivery. As we are aware of at least 8 additional trials [23–25,27–31] for CS and 1 trial [34] for VD published in recent 3 years, which are not included in any published meta-analyses. Thus, we aimed to identify all available data to evaluate whether the mode of delivery had a potential effect on the efficacy of TA in reducing estimated blood loss.…”

Role of intravenous tranexamic acid in reducing blood loss during caesarean section: Study at tribal‐dominated area hospital in Chhattisgarh, India

“…6 TXA has also been studied extensively to reduce blood loss in and after CS. [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] Intravenous TXA is a synthetic derivative of the amino acid lysine that exerts its antifibrinolytic effect through the reversible blockade of lysine binding site on plasminogen molecules. Adverse drug reaction of TXA are nausea, headache, and thromosis.…”