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. 2024 May;13(5):1760-1765.
doi: 10.4103/jfmpc.jfmpc_1541_23. Epub 2024 May 24.

Role of prophylactic tranexamic acid in reducing blood loss during cesarean section: A double-blind placebo-controlled randomized controlled trial

Nutan Sinha  1 , Sarita Rajbhar  1 , Pushpawati Thakur  1 , Sarita Agrawal  1 , Vinita Singh  1
Affiliations

Role of prophylactic tranexamic acid in reducing blood loss during cesarean section: A double-blind placebo-controlled randomized controlled trial

Nutan Sinha et al. J Family Med Prim Care. 2024 May.

Abstract

Background: Postpartum hemorrhage (PPH) is defined by the World Health Organization as blood loss of ≥500 mL within 24 h of delivery. Globally, hemorrhage accounts for 27.1% of maternal deaths, making it the leading direct cause of maternal death. PPH has been identified in more than two-thirds of reported hemorrhage-related deaths, causing 38% of maternal deaths in India. Tranexamic acid, an antifibrinolytic, has been used to control bleeding after PPH is identified.

Materials and methods: Antenatal women admitted for elective cesarean section were randomized into two arms: the case group (received one gram of tranexamic acid 20 min prior to skin incision) and the control group (received a placebo), each group consisting of 36 participants. Clinical Trials Registry - India (CTRI) registration number - CTRI/2021/02/031579.

Results: The mean (±standard deviation [SD]) intraoperative blood loss in the case group was 241.25 (±67.83) mL, and in the control group, it was 344.92 (±146.67) mL (P = 0.001), while postoperative blood loss did not differ significantly between the groups (P = 0.1470). In terms of the difference in hemoglobin, there was a significant difference between the two groups (P = 0.001). No significant maternal or neonatal side effects were found.

Conclusion: Preoperative tranexamic acid, when given in elective cesarean section, significantly reduces intraoperative blood loss.

Keywords: Antifibrinolytics; maternal morbidity; maternal mortality; obstetric hemorrhage; postpartum hemorrhage; tranexamic acid.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Participant randomization and treatment
Figure 2
Figure 2
Distribution of women according to indication. CPD = Cephalopelvic Disproportion, FGR = fetal growth restriction, ICP = interconception period
See this image and copyright information in PMC

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