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. 2016 Oct;66(Suppl 1):347-52.
doi: 10.1007/s13224-016-0915-x. Epub 2016 Jun 25.

Role of Intravenous Tranexamic Acid on Caesarean Blood Loss: A Prospective Randomised Study

Irene Ray  1 , Ratneshwar Bhattacharya  2 , Somajita Chakraborty  1 , Chiranjib Bagchi  3 , Sima Mukhopadhyay  4
Affiliations

Role of Intravenous Tranexamic Acid on Caesarean Blood Loss: A Prospective Randomised Study

Irene Ray et al. J Obstet Gynaecol India. 2016 Oct.

Abstract

Background: Post-partum haemorrhage (PPH) is a major cause of maternal mortality globally. Tranexamic acid, an anti-fibrinolytic agent, is a novel approach in an attempt to prevent this dreadful complication. This study aims to document the efficacy of intravenous (IV) tranexamic acid in reducing blood loss during and after caesarean section (CS).

Methods: In this prospective randomised placebo-controlled open-label study, 100 mothers scheduled for elective CS were randomly selected and divided into two groups (study and control) of 50 each. The study group received 1 g IV tranexamic acid and the control group received IV placebo. Following delivery, all mothers received ten units of oxytocin in 500 ml of normal saline.

Results: The mean intra-operative and post-partum blood loss were significantly lower in the study group than the control group: 499.11 ± 111.2 and 59.93 ± 12.5 ml versus 690.85 ± 198.41 and 110.06 ± 13.47 ml, respectively, (p < 0.001). Total blood loss was 30 % less in the study group (p < 0.001). Six mothers had PPH in the control group, while none in the study group. The difference between the pre-operative and post-operative haemoglobin levels was significantly less in the study group than the control group, 0.26 ± 0.22 versus 0.99 ± 0.48 g% (p < 0.001).There was no significant difference with respect to other haematological parameters. There was no added adverse effect or need for NICU admission in the study group.

Conclusion: Pre-operative IV tranexamic acid significantly reduced blood loss during elective CS without any significant adverse effects.

Keywords: Anti-fibrinolytics; Blood loss; Caesarean delivery; Post-partum haemorrhage; Tranexamic acid.

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Conflict of interest statement

The authors declare that they have no conflicts of interest. Research involving human participants and/or animals No animals were involved in this study. Only human participants were included in both case and control. Ethical approval All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed Consent Written informed consent has been taken from all patients participating in the trial.

Figures

Fig. 1
Fig. 1
Summary of study design
See this image and copyright information in PMC

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