Effect of Intravenous Administration of Tranexamic Acid in Reducing Blood Loss During and After Caesarean Section

Title: Effect of Intravenous Administration of Tranexamic Acid in Reducing Blood Loss During and After Caesarean Section

Authors: Khing Rushulo, Singh L Ranjit, Singh M Rameswar

DOI: http://dx.doi.org/10.18535/jmscr/v4i7.19

Abstract

Objective: To determine the effectiveness and safety of intravenous tranexamic acid in reducing blood loss during and after caesarean section.

Methods: A prospective randomised control study in which sixty subjects of caesarean deliveries who were included in the study were divided into two groups: Tranexamic acid (TXA) group – subjects who received tranexamic acid; and Control group - subjects who did not receive tranexamic acid. Intravenous tranexamic acid (Tranostat) 10mg/kg was administered 10 minutes prior to skin incision slowly over 5 minutes in the tranexamic acid group and 10ml of normal saline was administered in the placebo control group over 5 minutes intravenously. The amount of blood loss was measured on two occasions. The first period was from placental delivery to abdominal wound closure (in ml) and the second period from the end of LSCS to 2 hours after surgery (in ml).

Results: Tranexamic acid significantly reduced bleeding from the time of placental delivery to abdominal wound closure in LSCS with blood loss of 339.0 ± 18.4 ml in tranexamic acid (TXA) group compared to blood loss of 377 ±24 ml in control group. The reduction in blood loss was statistically significant (p value= 0.000). The blood loss from abdominal wound closure to 2 hours post delivery in TXA group and control group were 48.7 ± 9.1 ml and 58.4 ± 9.7 ml respectively and the difference was statistically significant (p value= 0.001). Thus the mean total blood loss was 388.0±22.8 ml and 432.4±30.8 ml in the TXA group and the control group, respectively. The result was found to be highly significant (p value= 0.001).

Conclusion: Tranexamic acid significantly reduced the amount of blood loss during and after lower segment caesarean section. It was not associated with any adverse drug reaction or thrombosis; hence it can be used safely in women undergoing LSCS.

Keywords- Tranexamic acid, Caesarean Section, placental delivery, closure, thrombosis

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Corresponding Author

Khing Rushulo

Post Graduate, Regional Institute of Medical Sciences, Imphal, Manipur, India

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