Role of Prophylactic Tranexamic Acid in Reducing Blood loss during Elective Caesarean section in Rural Area

Abstract

Background: To reduce maternal mortality and morbidity caused by bleeding, it is important to reduce the amount of bleeding during and after lower segment caesarean section (LSCS). Tranexamic acid helps to reduce bleeding during and after Caesarean section. Aim of the Work: To analyse the effectiveness of Tranexamic Acid (TXA) in reducing blood loss during elective caesarean section. Patients and Methods: The current study was conducted as a double blinded, randomized, controlled trial on 300 women recruited from labor ward in Kafr Elsheikh General Hospital whom planned to have scheduled casaerean section. A total number of 150 patients received tranexamic acid before induction of anesthesia in addition to oxytocin after delivery of the baby; the other 150 patients received oxytocin only. Results: In the current study, no significant difference between study and control groups as regards age (p 0.374). In the current study, no significant difference between study and control groups as regards gestational age (p 0.335). In the current study, number of soaked towels and amount of blood in suction set, which reflect the volume of blood loss from placental delivery to the end of surgery was significantly lower in study group than control group. In the current study, no significant difference between study and control groups as regards preoperative hemoglobin (p 0.614). Postoperative hemoglobin was significantly higher in study group than control group (p<0.004). Reduction in hemoglobin was significantly less in study group than control group (p<0.001). In the current study, no significant difference between study and control groups as regards preoperative hematocrit (p 0.527). Postoperative hematocrit was significantly higher in study group than control group (p0.17), Reduction in Hematocrit was significantly less in study group than in control group (p<0.001). In the current study, need to iron replacement or blood transfusion was significantly less frequent in study group than in control group (p<0.031). Conclusion: The use of tranexamic acid prior to cesarean section is significantly effective in reducing blood loss during caesarean section with no observed maternal or neonatal side effects. Recommendations: Further studies are needed to assess possibility of use of tranexamic acid for treatment of postpartum hemorrhage.