Effectiveness of Tranexamic Acid for Reducing Postpartum Blood Loss in the First Two Hours after Vaginal Delivery: A Randomised Controlled Trial
Journal Title: Journal of Clinical and Diagnostic Research - Year 2018, Vol 12, Issue 3
Abstract
ABSTRACT Introduction: Postpartum Haemorrhage (PPH) is the leading direct cause of maternal death worldwide, especially in developing countries. Fibrinolysis is an important process in bleeding during the third stage of labour. Tranexamic acid (TA) is used to reduce the fibrinolysis process which might reduce the blood loss after delivery. Aim: To study the effectiveness of intravenous TA for reducing postpartum blood loss in the first two hours after vaginal delivery. Materials and Methods: A prospective double blinded Randomised Controlled Trial (RCT) was performed. The participants were randomly allocated to receive either an intravenous infusion of TA (n=75) or a placebo (n=75) after delivery of the anterior shoulder. A prophylactic intramuscular injection of 10 units of oxytocin was used in both groups. Blood loss was directly measured using a collective bag combined with a gravimetric of gauzes and diapers during the first two hours postpartum. The means of blood loss of both groups were compared. The prevalence of PPH (>500 ml) and severe PPH (>1,000 ml) in both groups were analysed. Statistical analysis were performed using Stata13 (Stata Corp, College Station, TX). A p-value below 0.05 was considered statistically significant. Results: Seventy two participants in the TA group and 69 participants in the placebo group completed this study. Mean blood loss in the first two hours for the TA group was not significantly different from the placebo group (226.59±114.66 ml versus 234.05±142.41 ml, p=0.73). Adjusted mean difference was 4.61 ml (95% CI: -48.25 to 39.02). The frequency of PPH was one case in the TA group and three cases in the placebo group (one case was severe PPH). Only one woman had a mild side effect (nausea) and no episode of thrombosis occurred in the women who received TA. Conclusion: In normal delivery, the addition of TA did not reduce the amount of postpartum blood loss in the first two hours compared with prophylaxis oxytocin only.
Authors and Affiliations
Anuchat Sujita, Srisuda Songthamwat, Metha Songthamwat
Keywords
Related Articles
- EP ID EP513215
- DOI 10.7860/JCDR/2018/32494.11248
- Views 66
- Downloads 0
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