Place of Tranexamic Acid and Fibrinogen Association in the Management of Severe Postpartum Haemorrhage

Briki, Raja; Ferhi, Fahmi; Cherif, Ons; Saadi, Med Amine; Derouich, Mouna; Khlifi, Abdeljalil; Boughizane, Sassi; Tarmiz, K.

doi:10.4236/ojog.2018.811105

Cited by 1 publication

(3 citation statements)

References 27 publications

(17 reference statements)

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“…Out of the 20 studies examining TXA effectiveness, 14 (70%) were randomized controlled trials (RCTs) [ 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 ] and the rest non-randomized trials [ 32 , 33 , 34 , 35 , 36 , 37 ].…”

Section: Resultsmentioning

confidence: 99%

“…Overall, the trials tested TXA not only for PPH treatment but also for PPH prevention. While TXA was most of the time compared with routine care and placebo, a few studies used other comparators or combined TXA with other medications, including misoprostol sublingual [ 20 , 21 ], misoprostol per rectum [ 29 ], a prostaglandin analog [ 31 , 34 ], and fibrinogen [ 33 ].…”

Section: Resultsmentioning

confidence: 99%

“…As a medication to treat PPH, TXA was found effective for both vaginal and cesarean births in the studies by Ajroudi [ 32 ], Briki (in combination with fibrinogen) [ 33 ], and Dimassi (in combination with sulprostone) [ 34 ]. Diop found that the addition of sublingual TXA to misoprostol resulted in similar clinical and acceptability outcomes in vaginal births compared to treatment with misoprostol alone [ 21 ].…”

Section: Resultsmentioning

confidence: 99%

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Tranexamic Acid for Postpartum Hemorrhage Treatment in Low-Resource Settings: A Rapid Scoping Review

Tran

Bar-Zeev

Schulte-Hillen³

et al. 2022

IJERPH

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Tranexamic acid (TXA) effectively reduces bleeding in women with postpartum hemorrhage (PPH) in hospital settings. To guide policies and practices, this rapid scoping review undertaken by two reviewers aimed to examine how TXA is utilized in lower-level maternity care settings in low-resource settings. Articles were searched in EMBASE, MEDLINE, Emcare, the Maternity and Infant Care Database, the Joanna Briggs Institute Evidence-Based Practice Database, and the Cochrane Library from January 2011 to September 2021. We included non-randomized and randomized research looking at the feasibility, acceptability, and health system implications in low- and lower-middle-income countries. Relevant information was retrieved using pre-tested forms. Findings were descriptively synthesized. Out of 129 identified citations, 23 records were eligible for inclusion, including 20 TXA effectiveness studies, two economic evaluations, and one mortality modeling. Except for the latter, all the studies were conducted in lower-middle-income countries and most occurred in tertiary referral hospitals. When compared to placebo or other medications, TXA was found effective in both treating and preventing PPH during vaginal and cesarean delivery. If made available in home and clinic settings, it can reduce PPH-related mortality. TXA could be cost-effective when used with non-surgical interventions to treat refractory PPH. Capacity building of service providers appears to need time-intensive training and supportive monitoring. No studies were exploring TXA acceptability from the standpoint of providers, as well as the implications for health governance and information systems. There is a scarcity of information on how to prepare the health system and services to incorporate TXA in lower-level maternity care facilities in low-resource settings. Implementation research is critically needed to assist practitioners and decision-makers in establishing a TXA-inclusive PPH treatment package to reduce PPH-related death and disability.

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