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.
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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.
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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.
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Written informed consent has been taken from all patients participating in the trial.
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Dr. Irene Ray is a Senior Resident in Department of Obstetrics and Gynaecology, Medical College Kolkata; Dr. Ratneshwar Bhattacharya is an Assistant Professor in Department of Medicine, Icare Institute of Medical Science & Research and Dr. B. C. Roy Hospital; Dr. Somajita Chakraborty is an Associate Professor, Department of Obstetrics and Gynaecology, Medical College Kolkata; Dr. Chiranjib Bagchi is an Assistant Professor in Department of Clinical and Experimental Pharmacology, School of Tropical Medicine; Dr. Sima Mukhopadhyay is a Professor in Department of Obstetrics and Gynaecology, Icare Institute of Medical Science & Research and Dr. B. C. Roy Hospital.
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Ray, I., Bhattacharya, R., Chakraborty, S. et al. Role of Intravenous Tranexamic Acid on Caesarean Blood Loss: A Prospective Randomised Study. J Obstet Gynecol India 66 (Suppl 1), 347–352 (2016). https://doi.org/10.1007/s13224-016-0915-x
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DOI: https://doi.org/10.1007/s13224-016-0915-x