Zahra Naeiji1, Negar Delshadiyan2, Sorayya Saleh3, Atefeh Moridi4, Nayereh Rahmati5, Marzieh Fathi6. 1. Preventive Gynecology Research Center (PGRC); Department of Gynecology and Obstetrics, Shahid Beheshti University of Medical Science (SBUMS), Tehran, Iran. Electronic address: Zahranaeiji98@yahoo.com. 2. Gynecology and Obstetrics Resident, Shahid Beheshti University of Medical Science (SBUMS), Iran. 3. Department of Gynecology and Obstetrics, Shahid Beheshti University of Medical Science (SBUMS), Tehran, Iran. Electronic address: soraya_saleh2000@yahoo.co.uk. 4. Department of Gynecology and Obstetrics, Shahid Beheshti University of Medical Science (SBUMS), Tehran, Iran. Electronic address: Moridi59@gmail.com. 5. Gynecology and Obstetrics Fellow, Shahid Beheshti University of Medical Science (SBUMS), Iran. Electronic address: N136054@yahoo.com. 6. Iran University of Medical Sciences (IUMS), Iran. Electronic address: marziehfathi@yahoo.com.
Abstract
INTRODUCTION:Tranexamic acid is used as a known treatment of post-partum hemorrhage both in natural vaginal deliveries and cesarean sections, but its use in elective cesarean as a prophylactic measure to decrease the blood loss is not so common. OBJECTIVE: This clinical trial evaluates the efficacy and safety of tranexamic acid in decreasing the bleeding in women undergoing elective cesarean section. METHOD: 200 term singleton pregnant women who were scheduled for elective cesarean section were randomized to 2 groups and received a bolus of 1 gm tranexamic acid if body weight was <90 kg and 1.5 g if body weight was >90 kg diluted in 15 ml of 5% dextrose intravenously, or 5 ml of distilled water in 15 ml of 5% dextrose as placebo (before skin incision). Intra-operative and post-operative blood loss and hemoglobin levels were compared. RESULTS:Tranexamic acid decreased the mean blood loss by 25.3 % in our studied women. Mean volume of intra-operative blood loss was 391.1 (±67.4) ml in tranexamic acid group and 523.8 (±153.4) ml in control group which was statistically significant lesser with a 132.7 ml difference. Rate of >1000 ml and >500 ml bleeding and need to blood transfusion were also statistically significant lower in tranexamic acid group., mean hemoglobin level was statistically significant lower in placebo group than tranexamic acid group (11.77 ± 0.50 versus 11.31 ± 0.56) 6 h after cesarean section. No adverse reaction was documented. CONCLUSION: Prophylactic use of intravenous tranexamic acid decreases the blood loss safely in women undergoing elective cesarean section.
RCT Entities:
INTRODUCTION:Tranexamic acid is used as a known treatment of post-partum hemorrhage both in natural vaginal deliveries and cesarean sections, but its use in elective cesarean as a prophylactic measure to decrease the blood loss is not so common. OBJECTIVE: This clinical trial evaluates the efficacy and safety of tranexamic acid in decreasing the bleeding in women undergoing elective cesarean section. METHOD: 200 term singleton pregnant women who were scheduled for elective cesarean section were randomized to 2 groups and received a bolus of 1 gm tranexamic acid if body weight was <90 kg and 1.5 g if body weight was >90 kg diluted in 15 ml of 5% dextrose intravenously, or 5 ml of distilled water in 15 ml of 5% dextrose as placebo (before skin incision). Intra-operative and post-operative blood loss and hemoglobin levels were compared. RESULTS:Tranexamic acid decreased the mean blood loss by 25.3 % in our studied women. Mean volume of intra-operative blood loss was 391.1 (±67.4) ml in tranexamic acid group and 523.8 (±153.4) ml in control group which was statistically significant lesser with a 132.7 ml difference. Rate of >1000 ml and >500 ml bleeding and need to blood transfusion were also statistically significant lower in tranexamic acid group., mean hemoglobin level was statistically significant lower in placebo group than tranexamic acid group (11.77 ± 0.50 versus 11.31 ± 0.56) 6 h after cesarean section. No adverse reaction was documented. CONCLUSION: Prophylactic use of intravenous tranexamic aciddecreases the blood loss safely in women undergoing elective cesarean section.
Authors: Nguyen Toan Tran; Sarah Bar-Zeev; Catrin Schulte-Hillen; Willibald Zeck Journal: Int J Environ Res Public Health Date: 2022-06-16 Impact factor: 4.614