Tranexamic acid for cesarean section: a double-blind, placebo-controlled, randomized clinical trial

Abstract

Purpose: To assess the efficacy and safety of an intravenous formulation of tranexamic acid to reduce intrapartum and postpartum bleeding in patients giving birth by cesarean section.

Methods: Healthy women with normal pregnancies, at any gestational age, that we performed ceaserean section. Two hundred and twenty-three patients with cesarean section, were enrolled in a double-blind, placebo-controlled study. Tranexamic acid of 20 cc and a 20 cc 5 % dextrose solution was intravenously injected to the patients; both the study group (n = 101) and the control group (n = 122) 10 min before the start of cesarean section. We measured volume of blood loss in postoperative periods, decrease in hemoglobin and hematocrit levels after cesarean section. The mean follow up was 2 weeks after the operation.

Results: Tranexamic acid reduced intraoperative and postoperative blood loss. We did not observe any complications caused by TA such as venous thromboembolism, gastrointestinal problems and hypersensitivity.

Conclusions: This study confirms that tranexamic acid is effective in reducing intrapartum and postpartum bleeding in patients giving birth by cesarean section. Although some obstetricians are still worried about its thrombosis risk, our study shows that it can be used safely in aforementioned patients.