Efficacy of tranexamic acid in decreasing blood loss in elective caesarean delivery

Abstract

Objective: To evaluate the efficacy of tranexamic acid (TA) in decreasing blood loss during and after elective caesarean section (CS).

Methods: This prospective randomized trial was conducted among 124 pregnant women subjected to term elective CS. Patients were equally divided into two groups. Study group received 10 mg/kg TA intravenously 5 min before skin incision while the control group did not. In addition, both groups received 10 units oxytocin and 1 ml ergometrine after delivery of the fetus. Blood loss in both groups was measured from placental delivery to end of the surgery and from end of the surgery to 2 h postpartum. Hemoglobin and hematocrit values were determined preoperatively and on the third day postpartum (before discharge) for all cases. Maternal and neonatal adverse effects in study groups were recorded.

Results: TA group showed lower amount of blood loss (391 ml) when compared to control group (597 ml). Risk estimation has revealed that treatment with TA resulted in decrease in risk of postpartum blood loss by 30%. Hemoglobin and hematocrit levels were significantly lower in the control group on the third post-operative day.

Conclusion: TA reduces blood loss during and immediately after CS. Its use in caesarean delivery may be considered especially in cases where blood loss is expected to be high or in anemic patients.

Keywords: Cesarean delivery; postpartum blood loss; tranexamic acid.