Efficacy of Tranexamic Acid in Decreasing Blood Loss during and after Cesarean Section: A Randomized Case Controlled Prospective Study

Abstract

Postpartum hemorrhage is among the leading causes of maternal mortality throughout the world. Severe blood loss contributes to the increased blood transfusion risk with its concerned inherent adverse events and therefore increased rate of emergency re-operative interventions such as arterial ligation or hysterectomy. It also can lead to protracted anemia, particularly in low or median income countries. Objective: To study the efficacy and safety of tranexamic acid in reducing blood loss during and after the lower segment cesarean section. Method: A randomized, case controlled, prospective study was conducted on 100 women undergoing lower segment cesarean section (LSCS) Fifty of them were given tranexamic acid 1gm IV 20 mins before skin incision and were compared with fifty others to whom tranexamic acid was not given. Blood loss was collected and measured during two periods. The first period was from placental delivery to end of LSCS and second from the end of LSCS to 2 hours postpartum. RESULTS: Tranexamic acid significantly reduced the quantity of blood loss from the end of LSCS to 2 hours postpartum: 79.0±14.18 ml in the study group versus 128.57 ±23.72 ml in the control group (p=0.0001). It also significantly reduced the quantity of blood loss from placental delivery to 2 hours post-partum: 308.80±43.60 ml in the study group, versus 349.18 ± 42.17 ml in the control group. (P=0.0001). No complications or side effects were reported in either group. CONCLUSION: Tranexamic acid significantly reduced the amount of blood loss during and after the lower segment cesarean section and its use was not associated with any side effects or complication like thrombosis. Tranexamic acid can be used safely and effectively in women undergoing LSCS.