Assessment the role of tranexamic acid in prevention of postpartum hemorrhage

• Main Authors: Nevein Gerges Fahmy, Fahmy Saad Latif Eskandar, Walid Albasuony Mohammed Ahmed Khalil, Mohammed Ibrahim Ibrahim Sobhy, Amin Mohammed Al Ansary Amin
• Format: Article
• Language: English
• Published: SpringerOpen 2021-04-01
• Series: Ain Shams Journal of Anesthesiology
• Subjects: Antifibrinolytic; Cesarean section; Hyperfibrinolysis; Postpartum hemorrhage; Tranexamic acid
• Online Access: https://doi.org/10.1186/s42077-021-00154-6

Abstract Background Postpartum hemorrhage (PPH) is one of the leading causes of maternal mortality and morbidity worldwide. It is believed that hemostatic imbalance secondary to release of tissue plasminogen activator (tPA) and subsequent hyperfibrinolysis plays a major role in PPH pathogenesis. Antifibrinolytic drugs such as tranexamic acid (TXA) are widely used in hemorrhagic conditions associated with hyperfibrinolysis. TXA reduced maternal death due to PPH and its use as a part of PPH treatment is recommended, and in recent years, a number of trials have investigated the efficacy of prophylactic use of TXA in reducing the incidence and the severity of PPH. The study is aiming to assess the efficacy of tranexamic acid in reducing blood loss throughout and after the lower segment cesarean section and reducing the risk of postpartum hemorrhage. Results The amount of blood loss was significantly lower in the study group than the control group (416.12±89.95 and 688.68±134.77 respectively). Also the 24-h postoperative hemoglobin was significantly higher in the study group (11.66±0.79 mg/dl) compared to the control group (10.53±1.07mg/dl), and the 24-h postoperative hematocrit value was significantly higher in the study group (34.99±2.40) compared to control (31.62±3.22). Conclusion Prophylactic administration of tranexamic acid reduces intraoperative and postoperative bleeding in cesarean section and the incidence of postpartum hemorrhage.