Prophylactic use of tranexamic acid after vaginal delivery reduces the risk of primary postpartum hemorrhage

Saccone, Gabriele; Corte, Luigi Della; D’Alessandro, Pietro; Ardino, Bruno; Carbone, Luigi; Raffone, Antonio; Guida, Maurizio; Locci, Mariavittoria; Zullo, Fulvio; Berghella, Vincenzo

doi:10.1080/14767058.2019.1571576

Cited by 41 publications

(36 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Various approaches might be used taking the setting and availability of skilled birth attendants and supplies into consideration [ 17 ]. According to a metanalysis, prophylactic injection of tranexamic acid within 10 min after vaginal delivery will reduce the risk of primary PPH [ 18 ] and in women with established PPH the use of this medication can reduce the risk of adverse outcome like hysterectomy [ 19 ]. It has demostrated that early and aggressive treatment of PPH is a determinant of decreasing the morbidity and mortality associated with this worldwide health issue [ 20 , 21 ].…”

Section: Introductionmentioning

confidence: 99%

Prevalence, related factors and maternal outcomes of primary postpartum haemorrhage in governmental hospitals in Kabul-Afghanistan

Sighaldeh

Nazari

Maasoumi

et al. 2020

BMC Pregnancy Childbirth

View full text Add to dashboard Cite

Background: To determine the prevalence, related factors and maternal outcomes of primary PPH in governmental hospitals in Kabul Afghanistan. Methods: An observational study was designed to determine the prevalence, related factors and maternal outcomes of primary PPH in governmental hospitals in Kabul-Afghanistan. The population of this study consisted of all women who gave birth to a child between August and October 2018. The structured checklist was used to collect the data from patients who were suffering from primary PPH. Results: Among the 8652 women who were observed, 215 (2.5%) of them suffered from primary PPH and 2 (0.9%) of them died under caesarean section. The most common related factors of primary PPH were uterine atonia (65.6%), previous PPH (34.9%), prolonged labor (27%), genital tract trauma (26.5%), and induction of labor (20.5%). The most common maternal outcomes of primary PPH were respiratory failure (7%), hysterectomy (6%), and hypovolaemic shock (5.1%). Conclusions: According to our findings, the major cause of postpartum bleeding was uterine atonia. Therefore, postpartum care of women is essential, especially for those with previous PPH and prolonged labor that require more attention.

show abstract

Section: Introductionmentioning

confidence: 99%

Prevalence, related factors and maternal outcomes of primary postpartum haemorrhage in governmental hospitals in Kabul-Afghanistan

Sighaldeh

Nazari

Maasoumi

et al. 2020

BMC Pregnancy Childbirth

View full text Add to dashboard Cite

show abstract

“…Yet, recently there has been more focus on acute treatment of PPH with increased early use of tranexamic acid. Several studies have already shown and currently further studies are ongoing about the effective use of tranexamic acid as a first-line therapy or even prophylactic use for PPH [17,[26][27][28][29]. Other studies have indicated that the administration of carbetocin as well as oxytocin can effectively prevent PPH after vaginal delivery [30,31].…”

Section: Discussionmentioning

confidence: 99%

Red blood cell transfusion in obstetrics and its implication for patient blood management: a retrospective analysis in Switzerland from 1998 to 2016

Zdanowicz

Schneider

Mueller

et al. 2020

Arch Gynecol Obstet

View full text Add to dashboard Cite

Purpose Peripartum hemorrhage (PPH) remains one of the main causes of maternal mortality worldwide. Treatment includes administration of packed red blood cells (RBC) in severe cases and patient blood management (PBM) may reduce it significantly. In our study, we wanted to retrospectively assess red blood cell administration in PPH to evaluate the impact of PBM in Switzerland. Methods Using data from the Swiss obstetric hospital registry (Arbeitsgemeinschaft Schweizer Frauenkliniken, ASF), we included patients with deliveries from 1998 to 2016. We examined available obstetric data as well as blood loss and RBC administration in the acute and subacute peripartal phase. We categorized data into two time intervals: 1998-2011 and 2012-2016, as new PPH guidelines in Switzerland were established in 2012. Results PPH incidence increased between 1998 and 2016 significantly. The number of vaginal instrumental deliveries and cesarean sections increased as well. Administration of three or more RBC units, as defined in the ASF registry, in the acute and subacute phase in Switzerland has decreased after 2012. Conversely, we saw an increase in the administration of one to two RBC units in the acute and subacute phase. Nevertheless, overall RBC administration has been decreasing from 1998 to 2016. Conclusion The increase of patients obtaining one or two units of RBC for PPH suggests that there may be a potential for effective implication of PBM in obstetrics. Reduction of RBC transfusion in the context of PPH may not only decrease maternal morbidity, but decrease economic costs as well.

show abstract

“…PPH occurred in 8.5% of the tranexamic acid group vs 9.8% of the placebo group, and this difference was not statically significant (RR 0.83, 95% CI 0.68–1.01) 19 . However, a subsequent meta‐analysis of four clinical trials (N=4671) published by Saccone and colleagues found that women who received prophylactic tranexamic acid after vaginal delivery had a significantly lower risk of PPH (RR 0.61, 95% CI 0.41–0.91) 20 . Tranexamic acid may also have a life‐saving role among high‐risk women, such as those with anemia.…”

Section: Tranexamic Acid: Expanding Prevention and Treatment Options mentioning

confidence: 97%

“…19 However, a subsequent meta-analysis of four clinical trials (N=4671) published by Saccone and colleagues found that women who received prophylactic tranexamic acid after vaginal delivery had a significantly lower risk of PPH (RR 0.61, 95% CI 0.41-0.91). 20 Tranexamic acid may also have a life-saving role among high-risk women, such as those with anemia. We eagerly await the results of WOMAN-2 trial (NCT03475342), 21 which will enroll 10 000 women with moderate to severe anemia to determine the role of tranexamic acid in preventing PPH and other adverse maternal outcomes in this high-risk group.…”

Section: Acid For Preventing Postpartum Hemorrhage Following a Vaginalmentioning

confidence: 99%

Contemporary Issues in Women’s Health

Geary

Chibwesha

Stringer

2020

Intl J Gynecology & Obste

View full text Add to dashboard Cite

Prophylactic use of tranexamic acid after vaginal delivery reduces the risk of primary postpartum hemorrhage

Cited by 41 publications

References 18 publications

Prevalence, related factors and maternal outcomes of primary postpartum haemorrhage in governmental hospitals in Kabul-Afghanistan

Prevalence, related factors and maternal outcomes of primary postpartum haemorrhage in governmental hospitals in Kabul-Afghanistan

Red blood cell transfusion in obstetrics and its implication for patient blood management: a retrospective analysis in Switzerland from 1998 to 2016

Contemporary Issues in Women’s Health

Contact Info

Product

Resources

About