Effect of Prophylactic Tranexamic Acid on Peripartum Changes in Hemoglobin Concentration After Vaginal Delivery

Abstract

Objective: To evaluate the effect of prophylactic intravenous tranexamic acid on postpartum hemoglobin concentration values compared to control. Methods: This is a randomized controlled study involving 80 parturients with no apparent risk for PPH in a tertiary hospital who were grouped into two of 40 each. Group A received 10iu of oxytocin intramuscularly with 1000mg of intravenous tranexamic acid within one minute of having vaginal delivery of the baby while group B received intramuscular oxytocin 10iu with 10mls of sterile water and served as the control group. The primary outcome measure was the difference in admission and postpartum hemoglobin concentration (Hemoglobin change). Result: During the study period, 80 parturients that were recruited, completed the study. The characteristics of the parturients in the two groups had no significant statistical difference in their demographic characteristics and admission parameters (P>0.05). The mean postpartum hemoglobin concentration was significantly higher in the tranexamic acid plus oxytocin group compared to placebo plus oxytocin group (10.28+ 0.59ml) versus (9.44+0.62ml) p<0.005. There was no major maternal side effect in both groups. Conclusion: When compared with placebo plus oxytocin, tranexamic acid plus oxytocin was more effective in reducing postpartum hemoglobin drop after vaginal delivery. Tranexamic acid plus oxytocin is therefore recommended to be part of the active management of the third stage of labor.