The Role of Tranexamic Acid in Reducing Blood Loss During Elective Caesarean Section in a Tertiary Care Centre

Abstract

Introduction: The reduction of maternal mortality is one of the indicators under Goal 3- Ensure healthy lives and promote well-being for all at all ages of Sustainable Development Goals. It seeks to reduce global MMR to less than 70 per 100 000 live births by 2030. A leading cause of maternal mortality is Post-partum Haemorrhage (PPH). Hence, it is imperative that any improvement in maternal mortality rate must address the issue of Post-partum Haemorrhage. Post-partum Haemorrhage (PPH) is dened as the amount of blood loss in excess of 500 ml following the birth of the baby (World Health Organization). The clinical denition, which is more practical, states, any amount of bleeding from or into the genital tract following the birth of the baby up to the end of the puerperium, which adversely affects the general condition of the patient evidenced by the rise in pulse rate and falling blood pressure, is called Post-partum Haemorrhage. Aim: The present study is aimed to determine the clinical efcacy of tranexamic acid in reducing blood loss during elective caesarean section in Patna Medical College and Hospital, Patna. Type of study: Prospective study Study period: 1 year (January 2020 to December 2020) Materials and Methods: This is a prospective study conducted in Obstetrics and Gynaecology department at Patna Medical College and Hospital, Patna. 100 female patients scheduled for elective caesarean section are enrolled for the present prospective study, which was carried out from January 2020 to December 2020. The patients were randomly divided into 2 groups. 50 patients received 1g intravenous tranexamic acid 10 rd minutes before skin incision in addition to active management of 3 stage of labour and the other 50 patients were kept under the active rd management of 3 stage of labour only. Result: In the present study, the amount of blood loss was found to be signicantly low (mean 537 ml) in the tranexamic acid group as compared to the control group (608 ml), the difference was statistically signicant (p-value 0.001). The mean fall in haemoglobin level was also less (0.61 mg/dl) in the group which received the tranexamic acid as compared to the control group (1.07 mg/dl), the difference was statistically signicant (p- value 0.001). Postpartum haemorrhage (blood loss more than 1000 ml) was observed in 1 patient in the control group and no case of PPH was observed in the study group. Conclusion: To reduce blood loss following caesarean section, TXAmay be safely recommended in addition to Oxytocin.