Online ISSN: 2515-8260

Role of prophylactic use of tranexamic acid in reducing blood loss in cesarean sections

Main Article Content

Kandru Madhuri1 , Sneha Yadav2 , Sanjivani Ashok Deshpande3


Aims: To study the efficacy and safety of intravenous administration of tranexamic acid in reducing blood loss in caesarean sections. Objectives: To compare the volume of blood loss (intraoperative and postoperative) in both study and control group. To assess the difference between preoperative and postoperative hemoglobin and hematocrit levels in both study and control group. To assess the need for additional uterotonics in both groups and to assess the side effects of this drug in study group. Materials And Methods: Material: Pregnant women aged 19years and above, primiparous or multiparous with gestational age between 34 to 40weeks who were to undergo elective or emergency caesarean sections at Bharati Vidyapeeth Medical College and Hospital , Sangli were selected for this study. Informed written consent was taken from all consenting patients. Patient with history of thromboembolic disorders, any medical disorders ( renal, liver or cardiovascular diseases), severe hemorrhagic disease, anemia ( Hb< 9g/dl), anticoagulant therapy, allergy to tranexamic acid, morbid adherent placenta were excluded from this study. Method: A retrospective observational study was conducted for a duration of 6 months in 50 ANC patients who fulfilled the inclusion criteria. After taking informed consent, they were divided into two equal groups as study and control group. In study group, a bolus injection of 1 gram tranexamic acid diluted in 100ml normal saline was administered slowly 5-10mins before skin incision. No drug was given to control group. After delivery of neonate, routine care was given to both groups, that is 10 units oxytocin was added to ringer lactate and allowed to flow at rate of 75 to 100ml /hr for 3hours after surgery. Blood loss was measured in both the groups by gravimetric method. Hemoglobin and hematocrit values before and after the surgery was estimated and the percentage of difference was compared. Results: Hemoglobin and hematocrit values decreased significantly in control group than in study group. There was significant reduction of blood loss calculated from placental delivery till the end of surgery in study group as compared to control group. Similarly blood loss measured 24hrs after caesarean section was less in tranexamic acid group compared to control group. Tranexamic acid group has lesser requirement of uterotonic agents. There were no immediate postoperative complications or side effects to mother and neonate. Conclusion: Injection tranexamic acid is the antifibrinolytic agent when given with safe dose plays an effective role in decreasing blood loss during caesarean section. The use of this antifibrinolytic agent was not associated with any side effects or complications in the immediate postpartum period. Hence it can be used safely and effectively in subjects undergoing caesarean section.

Article Details