The Effect of Tranexamic Acid on Blood Loss After Vaginal Delivery and Caesarean Section

Abstract

Background: PPH is most common cause of maternal death, contributing to approximately 35% of maternal death all over the world. WHO (2017) recommended that tranexamic acid should be considered as a standard comprehensive PPH treatment package and must be used in all cases of PPH regardless of the cause of PPH. Objective: To evaluate the effectiveness and safety of intravenous Tranexamic acid (TA) for reduction of postpartum blood loss after vaginal delivery and LSCS and to record any adverse effects following its administration. Materials and Methods: This study was conducted as a randomized, double blind, placebo-controlled trial on females at high risk of PPH and delivered vaginally or via LSCS at our Institute. All the participants were randomly categorized into two groups study group (tranexamic acid) and control group. The two groups were compared with respect to efficacy (amount of blood loss and incidence of PPH) and safety (vitals and side effects). Results: Mean blood loss from the delivery of placenta to the end of delivery and from end of delivery to 2 hours postpartum was significantly lower in study group as compared to control group (p<0.05). Incidence of PPH was significantly higher in control group (p<0.05). There was no statistically difference in the vital at the time of delivery between two groups (p>0.05). Most common side effect due to tranexamic acid in study group was nausea (16%) followed by vomiting and diarrhea in 9% and 1% respectively. Conclusion: Tranexamic acid is an effective drug that can be used safely for prophylactic management of PPH regardless of its cause. This antifibrinolytic agent significantly reduce blood loss and incidence of PPH irrespective of type of delivery. Though, the drug is associated with minor side effects such as nausea, vomiting and diarrhea, it was not associated with major complications, thromboembolic phenomenon and maternal or perinatal morbidity and mortality.