Abstract
BackgroundPostpartum hemorrhage (PPH) is one of the leading causes of maternal mortality and morbidity worldwide. It is believed that hemostatic imbalance secondary to release of tissue plasminogen activator (tPA) and subsequent hyperfibrinolysis plays a major role in PPH pathogenesis. Antifibrinolytic drugs such as tranexamic acid (TXA) are widely used in hemorrhagic conditions associated with hyperfibrinolysis. TXA reduced maternal death due to PPH and its use as a part of PPH treatment is recommended, and in recent years, a number of trials have investigated the efficacy of prophylactic use of TXA in reducing the incidence and the severity of PPH.The study is aiming to assess the efficacy of tranexamic acid in reducing blood loss throughout and after the lower segment cesarean section and reducing the risk of postpartum hemorrhage.ResultsThe amount of blood loss was significantly lower in the study group than the control group (416.12±89.95 and 688.68±134.77 respectively). Also the 24-h postoperative hemoglobin was significantly higher in the study group (11.66±0.79 mg/dl) compared to the control group (10.53±1.07mg/dl), and the 24-h postoperative hematocrit value was significantly higher in the study group (34.99±2.40) compared to control (31.62±3.22).ConclusionProphylactic administration of tranexamic acid reduces intraoperative and postoperative bleeding in cesarean section and the incidence of postpartum hemorrhage.
Highlights
Postpartum hemorrhage (PPH) is one of the leading causes of maternal mortality and morbidity worldwide
Post-partum hemorrhage (PPH) was defined as blood loss more than 500 mL after a vaginal delivery and more than 1000 mL after a cesarean delivery; an updated and efficient definition has been suggested by American College of Obstetrics and Gynecology which stated PPH as cumulative blood loss more than or equal to 1000 mL or
The mean drop in 24-h postoperative hematocrit and hemoglobin levels were significantly lower in the tranexamic acid (TXA) group than in the control group
Summary
Postpartum hemorrhage (PPH) is one of the leading causes of maternal mortality and morbidity worldwide. PPH was defined as blood loss more than 500 mL after a vaginal delivery and more than 1000 mL after a cesarean delivery; an updated and efficient definition has been suggested by American College of Obstetrics and Gynecology which stated PPH as cumulative blood loss more than or equal to 1000 mL or PPH contributes significantly to maternal morbidity with the probability for intensive care admission, shock, acute renal failure, disseminated intravascular coagulation (DIC), adult respiratory distress syndrome (ARDS), hysterectomy, and loss of fertility (Committee on Practice Bulletins-Obstetrics 2017; Solomon et al 2012) Antifibrinolytic drugs such as tranexamic acid (TXA) are widely used in hemorrhagic conditions associated with increased fibrinolytic activity or hyperfibrinolysis (HF) like PPH (Pacheco et al 2017).
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