Study of the efficacy of tranexamic acid in reducing blood loss after child birth

Nagajyothi Gunturu, D. Shivani, P. Sravanthi


Background: The aim was to study the efficacy of tranexamic acid in reducing blood loss after childbirth in normal vaginal delivery and LSCS.

Methods: 200 pregnant women divided into two groups group 1 and group 2, 100 women undergoing LSCS and 100 women undergoing vaginal delivery. Study group will be given 1 g iv tranexamic acid along with active management of third stage of labor and control subjects will be given only active management of third stage. Clinical observations and laboratory examinations, measurement of blood loss were measured.

Results: Distribution with respect to indication of LSCS like fetal distress, cephalopelvic disproportion, abnormal presentation, previous LSCS, arrest of descent, failed induction and onset of labor were comparable between both the groups. Study group showed marked decrease in blood loss when compared to controls from time of placental delivery to 2 hours postpartum in women undergoing vaginal delivery and caesarean section. There was a significant fall in mean Hb level among the control group when compared with the study group. There was no significant difference in the vital signs of the subjects in both the groups. The incidence of adverse effect like nausea, vomiting and diarrhoea were not increased in the study group when compared to the control group. Also the incidence of thrombosis was not increased with tranexamic acid.

Conclusions: Tranexamic acid significantly reduced the amount of blood loss after vaginal delivery and lower segment caesarean section. Its use was not associated with any adverse drug reactions like nausea, vomiting, diarrhoea or thrombosis. Tranexamic acid can be safely administered in pregnant women undergoing vaginal delivery and lower segment caesarean section.



Tranexamic acid, Blood loss, Caesarean section, Thrombosis

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AbouZahr C. Antepartum and postpartum haemorrhage. In: Murray CJL, Lopez AD, eds. Health dimensions of sex and reproduction: the global burden of sexually transmitted diseases, HIV, maternal conditions, perinatal disorders and congenital anomalies. Cambridge, MA: Harvard School of Public Health; 1998: 165-89.

AbouZahr C. Global burden of maternal death and disability. Br Med Bull. 2003;67:1-11.

Guierriero C, Cairns J, Jayaram S, Roberts I, Perel P, Shakur H .Giving tranexamic acid to reduce surgical bleeding in sub Saharan Africa: an economic evaluation. Cost Eff Resour Alloc. 2010;8(1):1.

Lu MC, Fridman M, Korst LM, Gregory KD, Reyes C, Hobel CJ, et al. Variations in the incidence of postpartum hemorrhage across hospitals in California. Matern Child Health J. 2005;9(3):297-306.

Walzman M, Bonnar J. Effects of tranexamic acid in human milk after oral administration of tranexamic acid in lactating women. Stockh Swed Kabi AB. 1971.

Ker K, Prieto-Merino D, Roberts I. Systematic review, meta-analysis and meta- regression of the effect of tranexamic acid on surgical blood loss. Br J Surg. 2013;100(10):1271-9.

CRASH-2 trial collaborators. Effects of tranexamic acid on death, vascular occlusive events and blood transfusion in trauma patients with significant haemorrhage (CRASH-2): a randomised, placebo-controlled trial. Lancet. 2010;376(9734):23-32.

CRASH-2 collaborators, Roberts I, Shakur H, Afolabi A, Brohi K, Coats T, et al. The importance of early treatment with tranexamic acid in bleeding trauma patients: an exploratory analysis of the CRASH-2 randomised controlled trial. Lancet. 2011;377(9771):1096-101.

Hellgren M. Hemostasis during normal pregnancy and puerperium. Semin Thromb Hemost. 2003;29(2):125-30.

Gungorduk K, Yıldırım G, Asıcıoglu O, Gungorduk OC, Sudolmus S, Ark C. Efficacy of intravenous tranexamic acid in reducing blood loss after elective caesarean section: a prospective, randomized, double-blind, placebo-controlled study. Am J Perinatol. 2011;28(3):233-40.

Gohel M, Patel P, Gupta A, Desai P. Efficacy of tranexamic acid in decreasing blood loss during and after caesarean section: a randomised case controlled prospective study. J Obstet Gynecol India. 2007;57(3):227-30.

Abdel-Aleem H, Alhusaini TK, Abdel-Aleem MA, Menoufy M, Gulmezoglu AM. Effectiveness of tranexamic acid on blood loss in patients undergoing elective caesarean section: randomized clinical trial. J Matern Fetal Neonatal Med. 2013;26(17):1705-9.

Heesen M, Bohmer J, Klohr S, Rossaint R, Velde MV, Dudenhausen JW, et al. Prophylactic tranexamic acid in parturients at low risk for post-partum haemorrhage: systematic review and meta-analysis. Acta Anaesthesiol Scand. 2014;58(9):1075-85.

Mirghafourvand M, Mohammad-Alizadeh S, Abbasalizadeh F, Shirdel M. The effect of prophylactic intravenous tranexamic acid on blood loss after vaginal delivery in women at low risk of postpartum haemorrhage: a double-blind randomised controlled trial. Aust N Z J Obstet Gynaecol. 2015;55(1):53-8.

YangH, ZhengS, Shi C. Clinical study on the efficacy of tranexamic acid in reducing postpartum blood lose: a randomized, comparative, multicentre trial. Zhonghua Fu Chan Ke Za Zhi. 2001;36(10):590-2.