Role of intravenous tranexamic acid in reducing blood loss during caesarean section: Study at tribal-dominated area hospital in Chhattisgarh, India.

AIM: To evaluate the effect of low dose (1 g) of intravenous tranexamic acid (TXA) before caesarean delivery upon the mean blood loss during and after surgery as well side effects of the drug and to compare these effects with those who did not receive this medication in a referral hospital situated at the tribal terrain of Chhattisgarh.
METHODS: Total 100 women fulfilling inclusion criteria and shifted for caesarean section were studied. Fifty women comprising the study group were given one gram TXA (10 mL) intravenously over 10-20 min before skin incision whereas the other 50 women did not receive the drug (control group). Active Management of the Third Stage of Labor was done in all using 10 units of oxytocin intramuscularly within one minute of delivery of baby. The blood loss was quantified by the combination of gravimetric and direct measurement.
RESULTS: The mean blood loss (intra as well as postoperative) was 436.5 ± 118.07 mL in the study group in comparison to 616.5 ± 153.34 mL in the control group (P ≤ 0.05), only two (4%) women had a blood loss >500 mL during surgery versus nine (18%) (P ≤ 0.05), none versus three (6%) had PPH and postoperative mean change in the hemoglobin was 0.494 ± 0.12 g % versus 0.594 ± 0.16 g % (P ≤ 0.05) in the study and control groups, respectively. No adverse effects were reported in women or neonates.
CONCLUSION: TXA is a cheap, easily available antifibrinolytic drug that significantly reduces the intra and postoperative blood loss in caesarean section and is very useful for low resource settings.