Background: One of the leading causes of maternal morbidity and mortality globally, especially in developing nations, is remains postpartum haemorrhage (PPH). Compared to vaginal delivery, Caesarean sections are linked to an increased risk of excessive blood loss. By preventing fibrinolysis, the antifibrinolytic drug tranexamic acid (TXA) has been demonstrated to reduce surgical blood loss. The purpose of this study was to assess the safety and effectiveness of intravenous tranexamic acid in reducing intraoperative and postoperative blood loss during caesarean section.
Methods: This randomized controlled trial was conducted in the Department of Obstetrics and Gynaecology, Durgapur Steel Plant Hospital, West Bengal, from December 2019 to January 2021. Two groups (n = 50 each) of 100 term pregnant women undergoing caesarean sections were randomly assigned. Group 1 received intravenous tranexamic acid (1 g before skin incision followed by 500 mg 8-hourly for 2 days), while Group 2 received standard care without TXA. Blood loss was objectively measured intraoperatively and up to 2 hours postoperatively. Hemoglobin levels before and after surgery, incidence of PPH, need for additional uterotonics, maternal complications, and neonatal outcomes were assessed. SPSS version 21.0 was used for the statistical analysis, and p<0.05 was deemed significant.
Results: The TXA group had a significantly lower incidence of PPH than the control group (10% vs. 24%, p=0.04). 12% of the TXA group and 64% of the control group experienced blood loss above 500 ml (p<0.001). The TXA group experienced a significantly lower mean percentage decline in haemoglobin (7.32% vs. 16.7%, p<0.001). No significant maternal or neonatal adverse effects related to tranexamic acid were observed.
Conclusion: Intravenous tranexamic acid significantly reduces blood loss and hemoglobin decline during and after caesarean section without increasing maternal or neonatal complications. TXA is a safe and effective adjunct for the prevention of postpartum haemorrhage in caesarean deliveries.
International Journal of Clinical Obstetrics and Gynaecology
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