The use of Tranexamic Acid (TXA) Among Obstetricians and Gynecologists: A pilot study of current clinical practice.

Abstract

Objective: To investigate current practice patterns of tranexamic acid (TXA) use by Obstetricians and Gynecologists. Design: A cross-sectional, web based survey. Population: Members of the Central Association of Obstetricians and Gynecologists (CAOG). Methods: The anonymous survey regarding demographics, circumstances of use, and barriers of TXA use was emailed to CAOG members October 2018-December 2018. Results: There were 81 responses with a response rate of 27%. The majority of respondents were general obstetricians and gynecologists (63%). TXA used mostly during postpartum hemorrhage (72%), followed by heavy cyclic bleeding (42%), and then benign gynecological surgeries (5%). The majority of participants had TXA as part of their hospitals hemorrhage protocol (73%) and increase use was associated with having a hospital protocol (86%). The largest concern with TXA use was thromboembolic events (48%). The majority of respondents had a favorable view of TXA being incorporated into hospital protocols (95%). Conclusion: To our knowledge this is the first survey among obstetricians and gynecologist to elicit current practice patterns with TXA. This study illustrates an association between increase use of TXA when it is incorporated into a hospital protocol for postpartum hemorrhage. This finding suggests that to an individual provider, local hospital recognition of the safety and effectiveness of TXA is more impactful and influential than the World Health Organization to an individual obstetrician in practice. The major concern with TXA use was increased risk of a thromboembolic event, an overwhelming number of respondents would support incorporating TXA into their hospital's protocols