Efficacy of intravenous tranexamic acid in reducing blood loss during and after elective cesarean section

Abstract

Background Tranexamic acid (TXA) is one of the prominent amino acid lysine synthetic derivatives having its antifibrinolytic effect through the reversible blockade of the lysine-binding sites on plasminogen molecules. It is regularly administered intravenously to treat and avoid bleeding, with good results. Objective This study was carried out to evaluate the effectiveness, safety, and complications of using TXA in elective cesarean section (CS). Patients and methods This was a prospective study that was conducted at Al-Zahraa University Hospital and El Sahel Teaching Hospital on 200 patients planned for elective CS: 100 patients were given 1 g/10 ml TXA (group A) diluted with 20 ml of 5% glucose, whereas another 100 patients received 30 ml of 5% glucose (group B) 10 min before CS. Following the delivery, patients in both groups received a 5 IU intravenous bolus of pre-prepared oxytocin followed by 30 IU oxytocin in 500-ml lactated Ringer's solution, infused at a rate of 125 ml/h. An antibiotic, 1 g cefazolin, was diluted in normal saline of 20 ml, and it was administered over a duration of 5 min. Estimated blood loss was measured by comparing the hematocrit values before and after the procedure. Results The study revealed a statistically significant decrease in hemoglobin level in group B (placebo group) compared with group A (TXA group), which indicates that there was a significant reduction in the amount of intraoperative and postoperative blood loss in CS in TXA group. Conclusion The use of TXA before CS shows positive effects and can be used as a prophylaxis against postpartum hemorrhage, as revealed by the findings of this study.