Efficacy of prophylactic tranexamic acid administration in prevention of postpartum hemorrhage in placenta previa cesarean section: an interventional study

Monika Rathore, Anjali Gupta, Nidhi Kumari


Background: Postpartum hemorrhage accounts for the major part of the mortality as well as morbidity like severe anemia, need for blood transfusion, hospital stay and infection. Aim and objectives of the study were to determine the efficacy and safety of prophylactic tranexamic acid and intravenous tranexamic acid in preventing postpartum hemorrhage in women undergoing caesarean section for placenta previa.

Methods: Seventy women with placenta previa over 1 year, randomized into 2 groups: group 1 (n=35): Women who received 10 IU oxytocin intravenous infusion after placental delivery and group 2 (n=35): Women who received 1 gm (10 ml) tranexamic acid IV before skin incision plus 10 IU oxytocin intravenous infusion after placental delivery.

Results: The mean age was similar in 2 groups i.e., 26.34±4.78 years in group 1 and 27.31±5.62 years in group 2. Most women in the present study presented with type IV placenta previa i.e., 34.3% in group 1 and 48.6% in group 2. Mean pre-operative hemoglobin was 9.57±1.54 g/dl in group 1 and 9.59±1.35 g/dl in group 2. Intra-operative mean blood loss was 729.31±172.45 ml in intravenous oxytocin group and 464.86±28.00 ml in intravenous tranexamic acid group. A total of 74.3% women in group 1 and 20% women in group 2 developed postpartum hemorrhage. Mean post-operative hemoglobin was 8.04±1.34 g/dl in group 1 and 8.85±1.26 g/dl in group 2. In group 1, 5.7% neonates were born with very low birth weight and while none in group 2. 51.4% neonates in group 1 and 45.7% in group 2 had low birth weight.

Conclusions: It is concluded that tranexamic acid used prophylactically intravenously before skin incision in patients undergoing cesarean section for placenta previa significantly reduces intra-operative blood loss. 


Prophylactic tranexamic acid, Postpartum hemorrhage, Placenta previa, Cesarean section

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