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

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.