Safety Profile and Efficacy of Tranexamic Acid on Haemorrhage during and after the Caesarean Section

BACKGROUND

The interlink between Caesarean section, intraoperative and postoperative bleeding is well understood. Post-partum haemorrhage is one of the major causes of maternal morbidity and mortality. Tranexamic acid is a synthetic analogue of the amino acid lysine and its action is to reduce blood loss. Both antepartum and postpartum haemorrhage (PPH) are being treated by tranexamic acid extensively. The aim of the study is to evaluate the safety and efficacy of tranexamic acid given intravenously for reducing the intraoperative and postoperative blood loss in lower segment Caesarean section.

METHODS

In this randomised, placebo‑controlled, open‑label study, 100 pregnant women undergoing elective Caesarean section were selected in random pattern and divided into control and study group of 50 patients each, in the Department of Obstetrics andGynaecologyinChalmedaAnandRaoInstitute of Medical Sciences from January 2019 to January 2020. The study group of 50 subjects were given 1 g of tranexamic acid intravenously (IV) and the control group of 50 subjects were given IV 5 % dextrose. All the pregnant women received 10 units of oxytocin following delivery.

RESULTS

Based on the results, mean of the total blood loss in the study group was 30 % less than the control group. And also, a significant difference was observed in the haemoglobin concentration of the two groups, i.e., the study group had less difference in their preoperative and postoperative Hb values compared to the control group. No significant difference was found in the two groups regarding other parameters like systolic and diastolic blood pressure (BP), heart rate, prothrombin time (PT), activated partial thromboplastin time (aPTT). In our study, no side effects were statistically noted in both the groups.

CONCLUSIONS

Data analysis of our study suggests that, a safe dose of IV tranexamic acid prior to Caesarean section has an effective role in reducing blood loss without causing any side effects.