A randomized controlled trial on the effectiveness and safety of tranexamic acid in decreasing blood loss in cesarean section

Sianty Dewi


Background: WHO reported more than 100,000 maternal death due to obstetric hemorrhage annually, in other hand Cesarean Section (CS) is a common surgery done to save mother and child with one of the complications is hemorrhage. tranexamic acid (TXA) as antifibrinolytic might improve maternal outcome by decreasing blood loss in CS.
Objectives:Determine effectiveness and safety of tranexamic acid in decreasing blood loss in cesarean section.
Method:A prospective, double blinded, randomized controled study in Obstetrics and Gynecology Department of Southern Philippines Medical Center. The participants are 124 women underwent CS, 62 women given tranexamic acid after cord cut compared to 62 given placebo. Estimated blood loss, cardiac rate, systolic blood pressure before and after CS, events during CS and additional medicines. Hemoglobin and hematocrit was taken before and after CS, course in the ward, blood transfusion, adverse events, mortality and length of hospital stay were compared.
Results: Socio demographic, clinical profile, events after interventions, need of additional medicines and complications are similar for both group (p-value>0.05). The cardiac rate after CS is significantly higher in TXA group (tranexamic:85.1±11.5 placebo:80.1±15. 6, p-value=0.0441), but still in normal range.
Conclusion: Tranexamic acid is not recommended to be given routinely to reduce blood loss in CS, instead its more beneficence to abort severe bleeding hence its should be available during CS. There was no adverse events recorded in both treatment and placebo group showed safety of tranexamic acid.

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DOI: https://doi.org/10.33508/jwm.v2i1.1647