Ефективність транексамової кислоти під час терапії кровотечі у І триместрі вагітності

Abstract

The objective: to study the effectiveness of hemostatic therapy with tranexamic acid in pregnant women with miscarriage that started. Materials and methods: The study group included 110 pregnant women with a miscarriage that began with the onset of retrochoric hematoma, from 5 to 22 weeks of gestation. The main group was 60 pregnant women who received hemostatic therapy with the drug tranexamic acid Vidanol in a daily dose of 1000–1500 mg until stopping the bleeding. The comparison group consisted of 50 pregnant women who received standard hemostatic therapy with etamsylatum. On ultrasound, retrochorionic / retroplacental hematomas were noted in 27 women of the main group (45%) and 22 patients in the comparison group (44%), extramembrane hematomas were diagnosed in 8 (13.3%) and 9 (18%) women, respectively. Placenta presentation was observed in 7 (11.7%) and 8 (16%) women of both groups, respectively. In the rest of pregnant women there was a bloody discharge from the genital tract as a result of detachment of the chorion / placenta or membranes without formation of hematoma. The obtained data are processed by the statistical method using the Microsoft Excel computer program. Results. Stopping bleeding with the use of tranexamic acid averaged over 2 days from the start of therapy, the duration of bleeding was 2.1±0.2 days, whereas in the comparison group, the duration of bleeding was significantly higher than 5.7±0.3 (p<0,01). The need for inpatient treatment was in the main group of 9.7±0.8 bed-days and 15.6±2.7 bed-days, respectively (p<0.05). When using the drug tranexamic acid, the organization and resorption of hematomas in the uterus occurred in a shorter time – 19 of 35 (54.3%) women in the primary group and 10 in 31 (32.3%) women in the comparison group. The total absence of hematoma is noted in the main group for 1.2±0.4 weeks, in the comparison group for 4.8±0.5 weeks (p<0.05). Conclusion. The use of tranexamic acid, as hemostatic therapy in pregnant women with a miscarriage, significantly reduces the duration of bleeding, promotes the accelerating the organization and resorption of intrauterine hematomas, reduces the duration of inpatient treatment. Key words: pregnancy, miscarriage, risk of miscarriage, retrochorionic hematoma, bleeding in the first trimester of pregnancy.