Journal of Obstetrics and Gynecological Surgery A PLATFORM FOR SCIENTIFIC INQUIRY IN THE FIELD OF OBSTETRIC AND GYNECOLOGY FIELD

Effect of Tranexamic Acid in Prevention of Post-Partum Haemorrhage: A Prospective Observational Study

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10.52916/jogs234036

Priyanka Tripathi, Pramod Kumar, Shuchi M Jain, Shila Shelke*
Deptartment of Obstetrics Gynaecology, Mahatma Gandhi Institute of Medical Sciences, Wardha, Maharashtra, India.

Correspondence to: Shila Shelke, Deptartment of Obstetrics Gynaecology, Mahatma Gandhi Institute of Medical Sciences, Wardha, Maharashtra, India.
Received date: September 02, 2023; Accepted date: September 19, 2023; Published date: October 06, 2023
Citation: Tripathi P, Kumar P, Jain SM, et al. Effect of Tranexamic Acid in Prevention of Post-Partum Haemorrhage: A Prospective Observational Study. J Obst Gynecol Surg. 2023;4(2): 20-24. doi:10.52916/jogs234036
Copyright: ©2023 Tripathi P, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited.

Abstract

Background: Treatment of Post partum haemorrhage relies primarily on uterotonics, but early use of Tranexamic Acid (TXA) has become part of several recommended algorithms. Recent data has demonstrated that Tranexamic Acid (TXA), an antifibrinolytic agent, reduces death due to bleeding when used as a treatment for PPH. This study was conducted with an objective to see the role of tranexamic acid along with uterotonic agent (oxytocin) in prevention of postpartum hemorrhage.
Materials and Methods: The present prospective observational study carried out at the Maternal and Child Health (MCH) wing Department of a rural tertiary care hospital and medical college situated in the central India during January 2021 to December 2022. A total sample size of 1640 patients attending labour room for vaginal birth or caesarean section in 3rd stage of labour were included in the study. Total 1640 women were further divided into two groups, Group A (receiving both tranexamic acid along with oxytocin) and Group B (receiving only oxytocin). Blood loss in each group was measured by visual method and Gravimetric (measurement by weight) method. They were followed till delivery; maternal and neonatal outcome was studied. Statistical analysis was done by using SPSS 27.0 version and GraphPad Prism 7.0 version and p<0.05 considered as level of significance.
Results: The majority of patients in Group A and Group B were between 26-30 years of age group. There was no significant difference between the groups in terms of maternal age, gestational age, gravida and booking status. The mean foetal birth weight among Group A was 2421.28 ± 626.91 and Group B was 2381.38 ± 721.20 with no significant difference between the groups. There was significant reduction in blood loss in study group A as compared to control group in both vaginal and LSCS birth with statistically significant difference.
Conclusion: Tranexamic acid injection, an antifibrinolytic agent when given prophylactically after delivery of placenta along with oxytocin appears to reduce the blood loss during normal labour as well as caesarean sections effectively.

Keywords:

Tranexamic Acid (TXA), Prevention, Post-Partum Haemorrhage

Funding

No

Refernces

  1. Reyders FC, Seuten L, Tjalma W, et al Postpartum haemorrhage practical approach to a life threatening complication. Clin Exp Obstet Gynecol. 2006;33(2):81-84.
  2. WHO recommendations on prevention and treatment of postpartum haemorrhage. 2012.
  3. Committee on Practice Bulletins-Obstetrics. Practice bulletin no. 183: postpartum hemorrhage. Obstet Gynecol. 2017;130(4):e168- e86.
  4. Stapleton SR, Osborne C, Illuzzi J. Outcomes of care in birth centers: demonstration of a durable model. J Midwifery Womens Health. 2013;58(1):3-14.
  5. Menard KM, Main KE, Currigan MS. Executive summary of the reVITALize initiative: standardizing obstetric data definitions. Obstet Gynecol. 2014;124(1):150-153.
  6. Sebghati M, Chandraharan E. An update on the risk factors for and management of obstetric haemorrhage. Womens Health (Lond). 2017;13(2):34-40.
  7. Pacheco LD, Hankins GD, Saad AF, et al. Tranexamic acid for the management of obstetric hemorrhage. Obstet Gynecol. 2017;130(4):765-769.
  8. Arnold MJ, Keung JJ, McCarragher B. Interventional Radiology: Indications and Best Practices. Am Fam Physician. 2019;99(9):547-556.
  9. Urooj H, Shah M, Bukhari B, et al. Comparison of therapeutic effectiveness of oxytocin versus oxytocin plus tranexamic acid in the prevention of post-partum hemorrhage. J Postgrad Med Inst. 2021 Apr 1;35(2):11-23.
  10. Yang H, Zheng S, Shi C. Clinical study on the efficacy of tranexamic acid in reducing postpartum blood lose: a randomized, comparative, multicenter trial. 2001;36(10):590-592.
  11. Gungorduk K, Yıldırım G, Asıcıoğlu O, et al. Efficacy of intravenous tranexamic acid in reducing blood loss after elective cesarean section: a prospective, randomized, double-blind, placebo-controlled study. Am J Perinatol. 2011;28(03):233-40.
  12. Pusdekar Y.V, Patel AB, Kurhe KG. et al. Rates and risk factors for preterm birth and low birthweight in the global network sites in six low- and low middle-income countries. Reprod Health. 2020;17(Suppl 3):187.
  13. https://www.nhp.gov.in/disease/reproductive-system/female-gynaecological-diseases-/preterm-birth
  14. Sentilhes L, Daniel V, Deneux-Tharaux C, et al. TRAAP2 - TRAnexamic Acid for Preventing postpartum hemorrhage after cesarean delivery: a multicenter randomized, doubleblind, placebo-controlled trial- a study protocol. BMC Pregnancy Childbirth. 2020 Jan 31;20(1):63.
  15. Yates J, Perelman I, Khair S, et al. Exclusion criteria and adverse events in perioperative trials of tranexamic acid: a systematic review and meta‐analysis. Transfusion. 2019;59(2):806-824.
  16. Sudhof LS, Shainker SA, Einerson BD. Tranexamic acid in the routine treatment of post‐partum hemorrhage in the United States: a cost‐effectiveness analysis. Am J Obstet Gynecol. 2019; 221(3):275. e1275.e12.
  17. Abdul-Kadir R, McLintock C, Ducloy AS, et al. Evaluation and management of postpartum hemorrhage: consensus from an international expert panel. Transfusion. 2014;54(7):1756-1768.
  18. Sentilhes L, Winer N, Azria E, et al. Tranexamic Acid for the Prevention of Blood Loss after Vaginal Delivery. N Engl J Med. 2018 Aug 23;379(8):731-742.
  19. Abdel-Aleem H, Alhusaini TK, Abdel-Aleem MA, et al. Effectiveness of tranexamic acid on blood loss in patients undergoing elective cesarean section: randomized clinical trial. J Matern Fetal Neonatal Med. 2013;26(17):1705-1709.
  20. Wang HY, Hong SK, Duan Y, et al. Tranexamic acid and blood loss during and after cesarean section: a meta-analysis. J Perinatol. 2015;35(10):818-825.
  21. WOMAN Trial Collaborators. Effect of early tranexamic acid administration on mortality, hysterectomy, and other morbidities in women with post‐partum haemorrhage (WOMAN): an international, randomised, double blind, placebo‐controlled trial. Lancet. 2017;389(10084):2105-2116.
  22. Sentilhes L, Daniel V, Darsonval A, et al. Study protocol. TRAAP - TRAnexamic Acid for Preventing postpartum hemorrhage after vaginal delivery: a multicenter randomized, double-blind, placebo- controlled trial. BMC Pregnancy Childbirth. 2015;15(6):135.
  23. Li C, Gong Y, Dong L, et al. Is prophylactic tranexamic acid administration effective and safe for postpartum haemorrhage prevention?: A systematic review and meta-analysis. Medicine (Baltimore). 2017;96(1):e5653.
  24. Igboke FN, Obi VO, Dimejesi BI, et al. Tranexamic acid for reducing blood loss following vaginal delivery: a double-blind randomized controlled trial. BMC Pregnancy Childbirth. 2022;22(1):178.
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10.52916/jogs234036

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