scholarly journals The role of parenteral tranexamic acid in reducing blood loss in normal labour

2020 ◽  
Vol 9 (11) ◽  
pp. 4558
Author(s):  
Nandhini C. C. ◽  
Shanmugapriya .
Keyword(s):  
Blood Loss ◽  
Tranexamic Acid ◽  
Vaginal Delivery ◽  
Active Management ◽  
Normal Vaginal Delivery ◽  
Control Group ◽  
Inclusion Criteria ◽  
Blood Indices ◽  
Third Stage

Background: Obstetric blood loss can be reduced by using anti-fibrinolytic agents.Methods: 200 patients undergoing normal vaginal delivery and fulfilling the inclusion criteria were recruited for the study. In each patient pre-delivery and post-delivery vital parameters and blood indices were noted. The study group received injection tranexamic acid while the control group received only placebo injection in addition to the active management of third stage of labour. The amount of blood loss immediately after delivery and 2 hours after delivery were measured using blood drape and pre-weighed pads respectively.Results: There was a significant increase in the pulse rate and decrease in blood pressure in the control group. The post-delivery hemoglobin and hematocrit were significantly reduced in the control group. The blood loss at the end of 2 hours was more in the control group. The usage of additional uterotonics, need for blood transfusion, and duration of hospital stay was also increased in the control group.Conclusions: Tranexamic acid injection, an antifibrinolytic agent given intravenously after the delivery of the baby appears to reduce blood loss during normal vaginal delivery effectively.

scholarly journals Study of the efficacy of tranexamic acid in reducing blood loss after child birth

2021 ◽  
Vol 10 (5) ◽  
pp. 1863
Author(s):  
Nagajyothi Gunturu ◽  
D. Shivani ◽  
P. Sravanthi
Keyword(s):  
Caesarean Section ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Vaginal Delivery ◽  
Active Management ◽  
Control Group ◽  
Study Group ◽  
Lower Segment ◽  
Lower Segment Caesarean Section ◽  
Third Stage

Background: The aim was to study the efficacy of tranexamic acid in reducing blood loss after childbirth in normal vaginal delivery and LSCS.Methods: 200 pregnant women divided into two groups group 1 and group 2, 100 women undergoing LSCS and 100 women undergoing vaginal delivery. Study group will be given 1 g iv tranexamic acid along with active management of third stage of labor and control subjects will be given only active management of third stage. Clinical observations and laboratory examinations, measurement of blood loss were measured.Results: Distribution with respect to indication of LSCS like fetal distress, cephalopelvic disproportion, abnormal presentation, previous LSCS, arrest of descent, failed induction and onset of labor were comparable between both the groups. Study group showed marked decrease in blood loss when compared to controls from time of placental delivery to 2 hours postpartum in women undergoing vaginal delivery and caesarean section. There was a significant fall in mean Hb level among the control group when compared with the study group. There was no significant difference in the vital signs of the subjects in both the groups. The incidence of adverse effect like nausea, vomiting and diarrhoea were not increased in the study group when compared to the control group. Also the incidence of thrombosis was not increased with tranexamic acid.Conclusions: Tranexamic acid significantly reduced the amount of blood loss after vaginal delivery and lower segment caesarean section. Its use was not associated with any adverse drug reactions like nausea, vomiting, diarrhoea or thrombosis. Tranexamic acid can be safely administered in pregnant women undergoing vaginal delivery and lower segment caesarean section. 

scholarly journals The Efficacy of Intravenous Tranexamic Acid in Reduction of Blood Loss in Women at High Risk of Postpartum Hemorrhage

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
K M Diab ◽  
R M Mohamed ◽  
A G Abdelhay
Keyword(s):  
Blood Loss ◽  
Cesarean Section ◽  
Tranexamic Acid ◽  
Maternal Mortality ◽  
Vaginal Delivery ◽  
Control Group ◽  
Study Group ◽  
Control Groups ◽  
Significant Difference ◽  
And Control

Abstract Background Postpartum hemorrhage (PPH) is the leading cause of maternal mortality. All women who carry a pregnancy beyond 20 weeks’ gestation are at risk for PPH and its sequelae. Although maternal mortality rates have declined greatly in the developed world, PPH remains a leading cause of maternal mortality elsewhere. Aim of the Work To assess the efficacy and safety intravenous tranexamic acid in reduction of amount of blood loss in high risk women who deliver by cesarean section or vaginal delivery in postpartum period. Patients and Methods This prospective double blind randomized controlled clinical trial study was conducted on 200 patients planned for LSCS or vaginal delivery at Gestational Age ≥ 34 Weeks at Ain Shams University Maternity Hospital. Recruitment of data begun once the protocol was approved by research and ethical committee of the department of obstetrics and gynecology. Results No significant difference between Study and Control groups as regards age (p = 0.508), no significant difference between Study and Control groups as regards Gestational age (p = 0.447),total blood loss (p < 0.001) was significantly lower in study group than control group, Vaginal pads in the 1st 24 hours post-partum was significantly less soaked in study group than control group (p < 0.001). no significant difference between Study and Control groups as regards Preoperative Hemoglobin, Postoperative Hemoglobin was significantly higher in study group than control group (p < 0.001), Reduction in Hemoglobin was significantly less in study group than control group (p < 0.001), no significant difference between Study and Control groups as regards Preoperative Hematocrite, Postoperative Hematocrit was significantly higher in study group than control group (p < 0.001), Reduction in Hematocrite was significantly less in study group than control group (p < 0.001).Need to iron replacement or blood transfusion was significantly less frequent in study group than control group (p = 0.24). Conclusion The use of tranexamic acid prior to cesarean section or vaginal delivery is effective as a prophylaxis against post-partum hemorrhage as shown by the results of this study. It can significantly reduce blood loss during and after cesarean section or vaginal delivery.

scholarly journals A study of placental blood drainage in third stage of labour to prevent postpartum haemorrhage: a randomized controlled study

2021 ◽  
Vol 10 (11) ◽  
pp. 4226
Author(s):  
Jaya Kashinathrao Bhongle ◽  
Rashmi Agarwal
Keyword(s):  
Blood Loss ◽  
Cord Blood ◽  
Pregnant Women ◽  
Active Management ◽  
Controlled Study ◽  
Control Group ◽  
Study Group ◽  
Resource Setting ◽  
Third Stage ◽  
Placental Blood

Background: PPH is most common cause of maternal mortality accounting for 25-30% incidence and third stage of labour plays most crucial role in preventing postpartum haemorrhage.Methods: A prospective randomized control study in which 100 low risk pregnant women, admitted to labour ward with term gestation were evaluated. They were divided into 2 groups- control group (controlled cord traction) and study group (placental cord blood drainage), 50 pregnant women in each group. Duration of third stage and Amount of blood loss in third stage were evaluated and compared between the 2 groups.Results: Mean duration of third stage of labour in study group was 3.96±1.36 minutes and in control group was 6.00±2.12 minutes. The mean amount of blood loss in third stage of labour in study group was 99.80±56.47 ml in control group was 171.760±96.94 ml. Drop in haemoglobin level after delivery in control group was almost double than study group.Conclusions: Placental cord blood drainage in the management of third stage is non-invasive, easy, safe method which can be used in active management of third stage of labour as it has minimal interference in natural mechanism of placental separation. Placental cord blood drainage should be encouraged for management of third stage of labour universally to all pregnant women specifically in low resource setting areas.

scholarly journals Prophylactic use of tranexamic acid for reducing postpartum hemorrhage in vaginal delivery

2021 ◽  
Vol 10 (4) ◽  
pp. 1654
Author(s):  
Anusha Ginjupalli ◽  
Anuradha S. N. ◽  
Joshi Suyajna D.
Keyword(s):  
Blood Pressure ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Vaginal Delivery ◽  
Pulse Rate ◽  
Postpartum Hemorrhage ◽  
Control Group ◽  
Study Group ◽  
Normal Delivery ◽  
Number Of Patients

Background: The use of anti-fibrinolytic therapy has potential to reduce obstetric blood loss due to profound changes that take place in the fibrinolytic system during normal childbirth. Objective was to evaluate the efficacy of tranexamic acid in reducing postpartum hemorrhage (PPH) during normal labour.Methods: Patients who planned for normal delivery and fulfilling the inclusion criteria were recruited for the study. The pre-delivery parameters -pulse rate, blood pressure, Hb gm% and PCV% were measured for each patient. The study group received injection oxytocin (10 IU) and injection tranexamic acid (500 mg) slow intravenous route. The control group received injection oxytocin (10 IU) and placebo injection. Immediately after delivery of the anterior shoulder of the baby, when all the liquor was drained, Brasse-V drape is placed under the patient. Then the patient was given pre-weighed pads, which were weighed 2 hours post-partum. Final blood loss was calculated by combining amount of blood collected in the drape and blood absorbed by the pads.Results: The total number of patients studied was 300- equally distributed in both the groups. There was a significant increase in the pulse rate and decrease in blood pressure in the control group compared to the study group. The post-delivery haemoglobin and haematocrit were significantly reduced in the control group. The blood loss was significantly low in the study group. The need for other uterotonics, blood transfusion, and duration of hospital stay, were significantly low in study group.Conclusions: Tranexamic acid, when given prophylactically to the women with vaginal delivery who received prophylactic oxytocin, appears to reduce the blood loss effectively compared to placebo alone.

scholarly journals The effect and safety of placental blood drainage as a part of active management of third stage of labour in spontaneous vaginal delivery

2019 ◽  
Vol 8 (5) ◽  
pp. 1977
Author(s):  
Nidhi Gupta ◽  
Mohita Agarwal ◽  
Saroj Singh ◽  
Parul Gangwar
Keyword(s):  
Blood Loss ◽  
Uttar Pradesh ◽  
Active Management ◽  
Control Group ◽  
Study Group ◽  
Medical College ◽  
Third Stage ◽  
Placental Blood ◽  
The Mean ◽  
And Control

Background: In placental cord drainage facilitates placental delivery in both vaginal and caesarean section deliveries. The present study was done to evaluate the effect and safety of placental blood drainage as a part of active management of third stage of labour to reduce the duration and blood loss during third stage of labour.Methods: The study was conducted in department of Obstetrics and, SN Medical College, Agra, Uttar Pradesh, India on 400 term pregnant women, with single live intrauterine fetus in cephalic presentation, without any complication. They were randomly divided into to study and control group. Study group: It comprised of 200 Gynaecology cases, underwent active management of third stage of labour with placental blood drainage. Control group: It comprised of 200 cases, underwent active management of third stage of labour (AMTSL) alone. Duration and blood loss during third stage were noted.Results: The mean duration of third stage of labour was 3.61±0.972mins in study group and 8.15±1.711mins in control group. The mean blood loss during third stage of labour was 168.14±76.703ml and 287.40±85.808ml in study and control group respectively.Conclusions: Duration of third stage, blood loss during third stage, and hemoglobin deference between pre and post-delivery were reduced significantly in study group than control group.

scholarly journals Efficacy of tranexamic acid in preventing postpartum haemorrhage in vaginal delivery

2019 ◽  
Vol 8 (9) ◽  
pp. 3485
Author(s):  
G. Anantha Lakshmi Satyavathi ◽  
Chandrika K.
Keyword(s):  
Blood Loss ◽  
Tranexamic Acid ◽  
Postpartum Haemorrhage ◽  
Acid Group ◽  
Active Management ◽  
Singleton Pregnancy ◽  
Total Blood ◽  
Postpartum Blood Loss ◽  
Third Stage ◽  
History Of

Background: Postpartum blood loss is difficult to evaluate especially in developing countries like India where most of the women are anaemic with poor reserve and these conditions are further aggravated by increased demand during pregnancy and blood loss during third stage of labour. The present study was planned to compare the efficacy of prophylactic 10 IU intramuscular oxytocin and 10 IU intramuscular oxytocin +1g Tranexamic acid in reducing blood loss in the third stage of labour.Methods: The present study was carried out on full term pregnancies primigravida/ multiparas with singleton pregnancy being delivered vaginally at GSL Hospital, Rajahmundry between 2016-2017 were included. For this comparative study, 200 women in labor were included after obtaining informed consent. A detailed obstetric history, history of previous medical illnesses, history of the treatment received earlier, cardiovascular and respiratory system and other systems including thyroid and breast were noted.Results: The average total blood loss in IIIrd stage of labour with IM oxytocin was 210 ml and with IM oxytocin + Tranexamic acid was130 ml, which was statistically significant (p<0.001). Oxytocin + Tranexamic acid group had less blood loss when compared to oxytocin group alone. Side effects like, nausea vomiting, headache were slightly more with oxytocin + Tranexamic acid group when compared to oxytocin group alone.Conclusions: In the active management of IIIrd stage of labour 10 IU intramuscular Oxytocin + one gram of tranexamic acid IV is a better combination in reducing the blood loss at delivery when compared to 10 IU intramuscular oxytocin alone.

Carbetocin versus Oxytocin in Active Management of 3rd stage of Labour following Vaginal Delivery

2021 ◽  
Vol 7 (1) ◽  
pp. 927-931
Author(s):  
F Ashraf ◽  
Pervin Akther ◽  
N Yasmin ◽  
JA Islam ◽  
M Akther ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Adverse Effects ◽  
Blood Loss ◽  
Vaginal Delivery ◽  
Postpartum Hemorrhage ◽  
Active Management ◽  
Contraction Time ◽  
Duration Of Action ◽  
Massive Blood Loss ◽  
Third Stage

Background: Every day more than 220 women around the world die from severe bleeding after childbirth. Globally post-partum hemorrhage is the number one direct cause of maternal mortality. Most postpartum hemorrhages are caused by uterine atony and occur in the immediate postpartum period. Most of these tragic deaths can be prevented by active management of third stage of labour. Active management of the third stage of labor should be practiced routinely to decrease the risk of postpartum hemorrhage. Oxytocin is used for enhancing uterine contraction after delivery. But oxytocin has some limitations like shorter half- life, less contraction time and more side effects, whereas carbetocin has prolonged duration of action which ensures more contraction time and less adverse effects. This study was done to see the efficacy and safety of carbetocin over oxytocin for prevention of PPH after vaginal delivery. Methodology: A randomized controlled clinical trial was conducted in the Department of Obstetrics and Gynecology, Shaheed Suhrawardy Medical College and Hospital, Dhaka, Bangladesh over a period of 9 months from January 2015 to September 2015. Ninety four patients undergoing vaginal delivery at term were randomized into two groups receiving either 10IU oxytocin or 100 μg carbetocin. Outcome measures such as primary PPH, massive blood loss, need for additional uterotonic drug, additional blood transfusion as well as adverse effects were documented. Results: In this study, massive blood loss did not occur none of patients in carbetocin group. But massive blood loss occured 6.4% women of oxytocin group. Further fundal massage , immediate blood transfusion and additional uterotonics didn’t need any patient in carbetocin group. In oxytocin group, fundal massage required in 8.5% of women, blood transfusion needed in 10.6% patients and additional uterotonics needed in 10.6% women. Average amount of blood loss was 88 ml less in carbetocin group and adverse effects of drugs were almost similar in both group. Primary PPH developed in oxytocin group 8.5% but none of patients had developed PPH in carbetocin group. Conclusion: Carbetocin is an effective new drug than oxytocin for prevention of postpartum hemorrhage in vaginal delivery. Bioresearch Commu. 7(1): 927-931, 2021 (January)

scholarly journals Efficacy and Safety of Carbetocin in Comparison to Oxytocin in the Active Management of Third Stage of Labour Following Vaginal Delivery: An Open Label Randomized Control Trial

2016 ◽  
Vol 30 (1) ◽  
pp. 3-9 ◽  
Author(s):  
Nazneen Kabir ◽  
Dilruba Akter ◽  
Tahmina Afrin Daisy ◽  
Sonia Jesmin ◽  
Mollika Razzak ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Adverse Effects ◽  
Blood Loss ◽  
Vaginal Delivery ◽  
Controlled Trial ◽  
Active Management ◽  
Efficacy And Safety ◽  
Open Label ◽  
Massive Blood Loss ◽  
Third Stage

Objective(S):This study was conducted to evaluate the efficacy and safety of carbetocin in comparison to oxytocin in the active management of third stage of labour following vaginal delivery.Methods:A randomized-controlled trial was conducted in the Institute of Child and Mother Health (ICMH), Dhaka, Bangladesh over a period of nine months from January to September, 2015. Patients who got admitted in ICMH with labour pain were assessed by general examination, abdominal examination and labour status was confirmed by per vaginal examination. On the basis of selection criteria total 94 pregnant women who had undergone vaginal delivery were randomized for two groups of drugs. According to computer generated randomization sequential number was allocated for cases. One group of patients received intravenous 100 micro gram carbetocin and another group of patients received intramuscular 10 IU oxytocin in third stage of labour. Outcome measures such as amount of blood loss in 24 hours, primary PPH, massive blood loss, need of fundal massage, need for additional uterotonic therapy, blood transfusions as well as other adverse effects were all documented.Results: In this study, massive blood loss did not occur in any of patients in carbetocin group. But massive blood loss occurred in 8.5% women of oxytocin group. Further fundal massage, immediate blood transfusion and additional uterotonics were not needed by any patient in carbetocin group. In oxytocin group, fundal massage required in 10.6% of women, blood transfusion was needed for 6.4% patients and additional uterotonics was needed for 10.6% women. Average amount of blood loss were 64 ml less in carbetocin group and adverse effects of drugs were almost similar in both groups. Primary PPH was developed 6.4% in oxytocin group but none of patients developed PPH in carbetocin group.Conclusion: Carbetocin appears to be an effective new drug in the active management of third stage of labour in vaginal delivery. A single dose of 100 microgram IV carbetocin is more effective than oxytocin for maintaining adequate uterine tone, less blood loss and preventing postpartum bleeding in women undergoing vaginal delivery. So, carbetocin can be considered as a good alternative to oxytocin in the active management of third stage of labour in vaginal deliveryBangladesh J Obstet Gynaecol, 2015; Vol. 30(1) : 3-9

scholarly journals Role of methylergometrine versus oxytocin in the active management of third stage of labour: a randomised control trial

2021 ◽  
Author(s):  
Sabitha Umapathy Srinivasan ◽  
Swarnamukhi P.
Keyword(s):  
Blood Pressure ◽  
Blood Loss ◽  
Active Management ◽  
Randomised Control Trial ◽  
Routine Practice ◽  
Study Group ◽  
Randomized Design ◽  
Third Stage ◽  
The Mean

Background: Postpartum haemorrhage (PPH) is the leading cause of maternal death globally. The routine practice of active management of third stage of labour has been shown to reduce haemorrhage by up to 60%. The present study evaluated the role of methylergometrine versus oxytocin in active management of third stage of labour in reducing the risk of PPH.Methods: This study was conducted on a total of 400 women admitted in the labour ward of PESIMSR hospital, by using simple randomized design. The first study group included women who received intramuscular oxytocin (n=200) and, the second group included women who received intravenous Methylergometrine (n=200) within, one minute of delivery of the baby.Results: The mean blood loss among study first and the second study group were 172.8 ml and 148.9 ml respectively (p<0.05) and, the mean duration of third stage of labour were 5.9 and 5.1 minutes respectively (p<0.05). The mean pre-and post-delivery haemoglobin values among the first and second group were 11.76 mg/dl, 10.46 mg/dl and, 11.76 mg/dl, 10.6 mg/dl respectively (p<0.05). There was an increase in the blood pressure in the ergometrine group and, slight decrease of blood pressure in oxytocin group.Conclusions: The use of methyl ergometrine as part of active management of third stage of labour was associated with a significant reduction in mean blood loss value, duration of third stage of labour, and the additional need of oxytocic though, methylergometrine has significant side effects like nausea, vomiting and rise in blood pressure.

scholarly journals Placental cord drainage during third stage of labour: a randomized control trial at a tertiary care centre

2020 ◽  
Vol 9 (3) ◽  
pp. 1143
Author(s):  
Megha Chaudhary ◽  
Maitri Shah ◽  
Nitin Makwana
Keyword(s):  
Blood Loss ◽  
Randomized Control Trial ◽  
Tertiary Care ◽  
Normal Vaginal Delivery ◽  
Control Group ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Third Stage ◽  
The Mean ◽  
Randomized Control

Background: Labour is a physiological process, but it is often associated with morbidity and mortality, with the most common cause being blood loss. Primary postpartum hemorrhage is commonly defined as a blood loss of 500 ml or more within 24 hours after normal vaginal birth. A prolonged third stage of labour (more than 20 min) is associated with postpartum hemorrhage. The present study was undertaken with the objective of assessing efficacy of placental cord drainage (PCD) during active management of third stage of labour.Methods: This is a randomized control trial in which full term primi gravida who were expected to have normal vaginal delivery, admitted in labour room of a tertiary care centre were evaluated for inclusion in the study. Total 126 participants were enrolled after having normal vaginal delivery. In study group (n = 63), placental cord drainage was used for management of third stage of labour while in control group (n = 63), third stage was managed without PCD.Results: The mean difference in duration of third stage of labour in study and control group was 1.79 minute and the mean difference in blood loss during third stage of labour in both groups was 57.86 ml which was statistically significant.Conclusions: The results of this study show small positive effects from cord drainage in reducing the length of the third stage of labour and in reducing the amount of blood loss when compared with those without cord drainage. The observed changes may be of clinical significance in reducing third stage related complications.

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