ROLE OF PROPHYLACTIC TRANEXAMIC ACID IN REDUCING BLOOD LOSS DURING ELECTIVE CESAREAN SECTION

Abstract

Background: Post-partum hemorrhage (PPH) is a major cause of maternal mortality globally. Tranexamic acid, an anti-fibrinolytic agent is an attempt to prevent this complication. Objective: To identify the efficacy of intravenous (IV) tranexamic acid in reducing blood loss during elective cesarean section (CS). Patients and Methods: A Randomized Controlled Study was conducted on 200 women undergoing cesarean section. They were allocated to either Study or Control group by computer generated random number tables. Tranexamic acid (TXA) was given prior to surgery in study group in addition to the routine care (10 units of oxytocin added to the intravenous drip soon after baby delivery), whereas the control group had routine care alone. Blood loss was measured in both groups. Hemoglobin before and after surgery was estimated, and the percentage of difference was compared. Results: There was a significant reduction in blood loss calculated from placental delivery till end of surgery: 391.95 ml in study group versus 633 ml in control group (p < 0.000). Another parameter studied was the percentage of fall in hemoglobin before and after surgery. Postoperative hemoglobin was significantly higher in study group than control group (p < 0.000); Reduction in hemoglobin was significantly less in study group than control group by (0.76 ± 0.29 gm/dl) (p < 0.000). There were no immediate post-operative complications to the mother and neonate. Conclusion: Tranexamic acid (TXA) significantly reduced the amount of blood loss during Elective Cesarean Section (CS). Use of TXA was not associated with adverse effects. Thus, TXA can be used safely and effectively in subjects undergoing CS.