International Journal of Clinical Obstetrics and Gynaecology

Background and Objectives: There is a high risk of perioperative morbidity and blood transfusions because to the substantial intraoperative and postoperative blood loss that is prevalent during abdominal hysterectomy and other common gynecological surgeries. Several surgical techniques have demonstrated a decrease in blood loss when administered tranexamic acid (TXA), an antifibrinolytic drug.

Materials and Methods: This randomized controlled trial involved 60 women receiving elective abdominal hysterectomy for benign gynecological disorders. Patients were randomly assigned to two groups, each consisting of 30 individuals. Fifteen minutes before the skin incision, Group A had 10 mg/kg of tranexamic acid through an IV. Group B got the same amount of normal saline as a placebo. The blood loss, hemoglobin and hematocrit levels before and after surgery, the requirement for blood transfusion, and the side effects were all documented and examined statistically.

Results: On average, the tranexamic acid group experienced considerably less intraoperative blood loss (310.4±55.8 mL) than the control group (460.2±70.6 mL; p<0.001). In Group A, the average amount of blood lost by drains after surgery was 85.3±22.5 mL, which was lower than in Group B, which had 130.7±30.8 mL (p<0.01). Compared to the placebo group, the TXA group had a reduced mean drop in hemoglobin and hematocrit levels postoperatively (Hb: 0.9±0.4 g/dL; Hct: 2.5±1.1%). In the TXA group, 6.7% of patients needed a blood transfusion, but in the control group, 26.7% did. We did not observe any serious side effects or thromboembolic complications.

Conclusion: Without any adverse effects, intravenous tranexamic acid given before abdominal hysterectomy significantly lessens blood loss during and after the operation, keeps hemoglobin levels stable after surgery, and lessens the necessity for blood transfusions. Patients having an abdominal hysterectomy would benefit from its regular use since it is a safe and inexpensive way to enhance perioperative outcomes.