THE EFFICACY OF INTRAVENOUS TRANEXAMIC ACID IN REDUCTION OF BLOOD LOSS IN WOMEN AT HIGH RISK OF POSTPARTUM HEMORRHAGE
Radwa M. Mohamed, Khaled M. Diab, Ahmed G. Abdelhay
Department of Obstetrics and Gynecology Faculty of Medicine Ain Shams University
Background: Postpartum hemorrhage (PPH) is the leading cause of maternal mortality. All women who carry a pregnancy beyond 20 weeks’ gestation are at risk for PPH and its sequelae. Although maternal mortality rates have declined greatly in the developed world, PPH remains a leading cause of maternal mortality elsewhere. Aim of the Work: To assess the efficacy and safety intravenous tranexamic acid in reduction of amount of blood loss in high-risk women who deliver by cesarean section or vaginal delivery during postpartum period. Patients and Methods: This prospective double blind randomized controlled clinical trial was conducted on 200 patients planned for LSCS or vaginal delivery at gestational age ≥ 34 weeks, with one or more risk factor for PPH. Women were divided into two groups evenly and assigned randomly to receive either tranexamic acid 1 gm slowly intravenously or placebo after delivery. Total blood loss, pre labor and post labor hemoglobin and heamatocrit were recorded. Results: there was no significant difference between study and control groups as regards demographic data and risk factors to develop PPH. Total blood loss was significantly lower in study group than control group. Reduction in hemoglobin and hematocrite was significantly less in study group than in control group. There was no difference between the two groups regarding the rate of blood transfusion and hysterectomy. Conclusion: The use of tranexamic acid prior to cesarean section or vaginal delivery is effective as a prophylaxis against post-partum hemorrhage in women with risk factors for bleeding.