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 Assessment the role of tranexamic acid in prevention of postpartum hemorrhage

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Nevein Gerges Fahmy ◽  
Fahmy Saad Latif Eskandar ◽  
Walid Albasuony Mohammed Ahmed Khalil ◽  
Mohammed Ibrahim Ibrahim Sobhy ◽  
Amin Mohammed Al Ansary Amin
Keyword(s):  
Blood Loss ◽  
Cesarean Section ◽  
Tranexamic Acid ◽  
Postpartum Hemorrhage ◽  
Postoperative Bleeding ◽  
Control Group ◽  
Study Group ◽  
Mortality And Morbidity ◽  
Lower Segment Cesarean Section ◽  
Prophylactic Use

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.

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 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 Effect of intravenous oxycodone on the physiologic responses to extubation following general anesthesia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Menglu Jiang ◽  
Jiawei Ji ◽  
Xin Li ◽  
Zhenqing Liu
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
General Anesthesia ◽  
Control Group ◽  
Study Group ◽  
Clinical Trial Registry ◽  
Blood Oxygen Saturation ◽  
Blood Concentrations ◽  
Number Of Patients ◽  
Blood Hormones

Abstract Background Endotracheal intubation and extubation may cause undesirable hemodynamic changes. Intravenous oxycodone has recently been introduced and used for relieving hemodynamic alterations in response to intubation, but there is insufficient information regarding its application in stabilizing hemodynamics during extubation in the patients emerging from general anesthesia. Methods One hundred patients, who had undergone assorted laparoscopic surgeries under general anesthesia, were randomly assigned to Control group (saline injection, 50 cases) and Study group (intravenous injection of 0.08 mg/kg oxycodone immediately after completion of the surgical procedure, 50 cases). Blood pressure, heart rate, blood oxygen saturation (SpO2) as well as blood concentrations of epinephrine, norepinephrine, and cortisol were recorded or measured immediately before extubation (T0), during extubation (T1), as well as one minute (T2), 5 min (T3), and 10 min after extubation (T4). In addition, coughing and restlessness, time of eye-opening, and duration from completing surgery to extubation as well as Ramsay Sedation Scale were analyzed. Results Blood pressure and heart rate as well as blood concentrations of epinephrine, norepinephrine, and cortisol were significantly higher in the Control group compared with the Study group at the time of extubation as well as 1, 5, and 10 min after extubation (P < 0.05). When the patients emerged from general anesthesia, 70 % of the Control group had cough, which was significantly higher than that of Study group (40 %, P < 0.05). Significantly higher number of patients manifested restlessness in the Control group before (40 %) and after extubation (20 %) compared with that in the Study group (20 and 2 %, respectively, P < 0.05). In addition, patients of Control group had lower Ramsay score at extubation (1.7 ± 0.7) as well as 30 min after extubation (2.4 ± 0.9) compared to that of the patients of Study group (2.2 ± 0.9, and 3.0 ± 0.8, respectively, P = 0.003 and 0.001). Conclusions Intravenous oxycodone attenuated alterations of hemodynamics and blood hormones associated with extubation during emergence from general anesthesia. Trial registration Chinese Clinical Trial Registry: ChiCTR2000040370 (registration date: 11-28-2020) “‘retrospectively registered”.

scholarly journals Tranexamic acid in prevention of postpartum hemorrhage in elective cesarean section

2019 ◽  
Vol 8 (2) ◽  
pp. 372
Author(s):  
Pravin Shah ◽  
Ajay Agrawal ◽  
Shailaja Chhetri ◽  
Pappu Rijal ◽  
Nisha K. Bhatta
Keyword(s):  
Blood Loss ◽  
Cesarean Section ◽  
Tranexamic Acid ◽  
Postpartum Hemorrhage ◽  
Elective Cesarean Section ◽  
Controlled Study ◽  
Control Group ◽  
Estimated Blood Loss ◽  
Elective Cesarean ◽  
The Mean

Background: Postpartum hemorrhage is a common and occasionally life-threatening complication of labor. Cesarean section is associated with more blood loss in compared to vaginal delivery. Despite, there is a trend for increasing cesarean section rates in both developed and developing countries thereby increasing the risk of morbidity and mortality, especially among anemic women. The objective of this study was to evaluate the effect of preoperative administration of intravenous Tranexamic acid on blood loss during and after elective cesarean section.Methods: This was a prospective, randomized controlled study with 160 eligible pregnant women of 37 or more period of gestation. They were all planned for elective cesarean section and were randomized into two groups either to receive 10ml (1gm) of Tranexamic acid intravenously or 10ml of normal saline. Blood loss was measured during and for 24 hours after operation.Results: The mean estimated blood loss was significantly lower in women treated with Tranexamic acid compared with women in the placebo group (392.13 ml±10.06 vs 498.69 ml±15.87, respectively; p<0.001). The mean difference in pre-operative and post-operative hemoglobin levels was statistically significant in the Tranexamic acid group than in the control group (0.31±0.18 vs 0.79±0.23, respectively; p<0.001).Conclusions: Pre-operative use of Tranexamic acid is associated with reduced blood loss during and after elective cesarean section. In a developing country like ours where postpartum hemorrhage is a major threat to the life of the mothers, it seems to be a promising option.

scholarly journals Efficacy of Tranexamic Acid in Reducing Blood Loss during and After Caesarean Section: A Case control Study

2020 ◽  
Vol 18 (1) ◽  
pp. 22-25
Author(s):  
Kavita Sinha ◽  
Subhash Pandey ◽  
Dipendra Khadka
Keyword(s):  
Caesarean Section ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Apgar Score ◽  
Postpartum Haemorrhage ◽  
Group Versus ◽  
Control Group ◽  
Study Group ◽  
Lower Segment ◽  
Lower Segment Caesarean Section

Introduction: The incidence of caesarean section is increasing day by day. One of the most common complications is primary or secondary postpartum haemorrhage. Tranexamic acid has been shown to be very useful in reducing blood loss and incidence of blood transfusion in varieties of surgery. Aims: To study the efficacy of tranexamic acid in reducing blood loss during and after the lower segment caesarean section. Methods: Arandomized, case controlled, prospective study was conducted on 100 women undergoing lower segment caesarean section carried out in the Department of Obstetrics and Gynaecology, Nepalgunj Medical College, Kohalpur from Sept 2019 to Feb 2020.Fifty of them were given tranexamic acid immediately before lower segment caesarean section and were compared with 50 others to whom tranexamic acid was not given. Blood loss was collected and measured during two different time interval. The first period was considered from placental delivery to end of lower segment caesarean section and second from the end of lower segment caesarean section to 2 hours postpartum period. Vital signs at time of delivery, at 1 hour and 2 hour postpartum and APGAR score at 1 min and 5 min were studied in both the groups. Results: Tranexamic acid significantly reduced the quantity of blood loss from the placental delivery to 2 hours post-partum: 360.9 ml in the study group, versus 443 ml in the control group (p=0.0008).It also significantly reduced the quantity of blood loss from the end of  lower segment caesarean section to 2 hours postpartum:71.5 ml in the study group versus 112.6 ml in the control group (p=0.0002).There was 18% less incidence of postpartum haemorrhage , who received tranexamic acid(p=0.02).There were no significant adverse drug reaction and difference in APGAR score in both the groups. No complications or side effects were reported in either group. Conclusion: Tranexamic acid is safe and effective in reducing blood loss among women undergoing lower segment caesarean section.

scholarly journals The effect of oral tranexamic acid administration on blood loss and hospital costs in patients undergoing total knee arthroplasty

2017 ◽  
Vol 5 (2_suppl2) ◽  
pp. 2325967117S0006
Author(s):  
Budak Akman ◽  
Burak Çağrı Aksu ◽  
Çağatay Uluçay ◽  
Volkan Kılınçoğlu ◽  
Turhan Özler ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Knee Arthroplasty ◽  
Hospital Costs ◽  
Oral Dosage ◽  
Control Group ◽  
Study Group ◽  
Total Knee ◽  
Acid Administration

Aim: Total knee arthroplasty is a kind of major orthopaedic operation that may go with serious amount of peroperative blood loss. Tranexamic acid administration (an antifibrinolytic agent) is one of the most common strategy among the various blood preserving strategies used in major surgeries associated with high volume blood loss. The aim of this study is to evaluate effectiveness of oral tranexamic acid in reducing blood loss and blood transfusion in total knee arthroplasty procedures. In addition hospital costs were also compared. Materials-Methods: Between 2013-2016, 256 total knee arthroplasty procedure performed by six different staff surgeons in our clinic. 125 patients appropriate for our study criteria were included in our study and retrospectively evaluated. 49 patients in study group were administered 15 mg/kg tranexamic intravenous infusion before relasing intraoperative tourniquet and continued as oral 500 mg tranexamic acid three times with 6 hours interval in the first postoperative 24 hours.76 patients were not administered tranexamic acid and compromised the control group. Information on pateints’s demographics, preoperative and postoperative 24th hour hemoglobin and hematocrit values, postoperative 24th hour drain volumes and blood transfusions were obtained from patient files retrospectively. Results: Postoperative 24th hour drain volumes were significiantly less in tranexamic acid administered group (283 130 cc) than that of control group (383 135 cc) (p<0,001). Decrease in hemoglobin and hematocrit values in the postoperative 24th hour were significiantly less in study group (1,73 g/dL-%6,13) than those of control group (2,92 g/dL -%8,63) (P<0,001). Both number of total erythrocyte suspensions (ES) transfused and number of patients transfused were higher in control group than those of study group. (52 ES and 45 patients versus 18 ES and 14 patients) Calculated average ES per patient were 0.37 in study group and 0.68 in control group. (P=0,009). As a result blood bank costs were reduced %50 in study group as compared to control group. Conclusions: Tranexamic acid administered as single intraoperative intravenous dose and sequentially continued as 500 mg oral dosage 3 times with six hours interval in the first postoperatve24 hours is a significiantly effective approach in preventing bloos loss and reducing hospital costs in total knee arthroplasty procedures. In addition easiness and convinience of oral administration of tranexamic acid makes the approach more advantageous.

scholarly journals Uterotonic effect of rectal misoprostol as preoperative medication for assessment of intraoperative and postoperative blood loss in cesarean delivery

2021 ◽  
Vol 10 (4) ◽  
pp. 1415
Author(s):  
Urmila Karya ◽  
Shweta Maheshwari ◽  
Anupam Rani
Keyword(s):  
Blood Loss ◽  
Cesarean Delivery ◽  
Postpartum Hemorrhage ◽  
Controlled Trial ◽  
Safe Motherhood ◽  
Postoperative Blood Loss ◽  
Control Group ◽  
Study Group ◽  
Elective Cesarean ◽  
Randomised Controlled

Background: Postpartum hemorrhage is the leading cause of maternal mortality and it's prevention has been identified as key component of safe motherhood. Misoprostol is an effective uterotonic for prophylaxis and control of PPH. Aim of our study was to evaluate the effect of preoperative rectal misoprostol (400μg) on blood loss during and after cesarean delivery.Methods: It was a randomised controlled trial done on 200 women scheduled for elective cesarean delivery. Eligible participants were randomized into two groups. In the study group 100 women received a preoperative 400 μg per rectal misoprostol tablet just after spinal anaesthesia while 100 women assigned to the control group did not receive misoprostol tablet.Results: The mean intra operative and postoperative blood loss was lower in study group than the control group 345.98±79.57 ml and 114±19.97 ml versus 408.6±63.68 ml and 136.38±24.81 ml, respectively. The difference between the preoperative and postoperative hematocrit values was also significantly lower in the study group than the control group (33.43±1.93 and 33.64±1.82)Conclusions: In our study it was concluded that preoperative 400 μg rectal misoprostol is effective in reducing intraoperative and postoperative blood loss, thus preventing postpartum hemorrhage and reducing incidence of overall maternal morbidity and mortality.

scholarly journals Efficacy and safety of pre-operative single dose parenteral tranexamic acid in moderately anaemic parturients undergoing caesarean section

2017 ◽  
Vol 6 (8) ◽  
pp. 3423
Author(s):  
Robin Medhi ◽  
Sonika Bawri ◽  
Chaitra S.K. ◽  
Mansur Ahmed ◽  
Asmita Mishra
Keyword(s):  
Caesarean Section ◽  
Blood Transfusion ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Postoperative Blood Loss ◽  
Control Group ◽  
P Value ◽  
Study Group ◽  
Total Blood ◽  
Moderate Anaemia

Background: Preoperative administration of Tranexamic acid (TXA) has been found to be effective in reducing the amount of blood loss following Caesarean section in low risk women. However, studies in high risk women such as women with anaemia, where blood loss needs to be minimised are scarce.Methods: An experimental case control study was conducted with a total of 174 patients with moderate anaemia undergoing CS in a teaching hospital. Study group consisting of 87 patients received pre-operative TXA 1g intravenously. Intra operative and up to 6hours postpartum blood loss was calculated in both the groups. Requirement of blood transfusions were noted. Data analysed using Graphpad Instat® 3 statistical software.Results: Present study showed statistically significant reduction in intraoperative and postoperative blood loss among patients who received TXA compared to control group. The blood loss from placental delivery till completion of the procedure was significantly lowered (304.02ml vs 393.36ml; p value <0.0001). Postoperative blood loss (from end of the procedure up to 6hrs postpartum) was 62.57ml in comparison to 85.40ml in control group (p value <0.0001). The total blood loss from the placental delivery up to 6 hours postpartum was significantly reduced in study group (366.59ml vs 478.76ml; p value <0.0001). There was significant reduction of blood transfusion in study group (RR: 0.20, 95% CI, 0.045-0.887), without immediate adverse effect on mothers and new-borns.Conclusions: Administration of TXA preoperatively causes significant decrease in blood loss and the need for blood transfusion in patients with moderate anaemia undergoing CS. 

scholarly journals IMMERSION HANDS AND FEET IN WARM WATER TO REDUCE PERINEAL PAIN AFTER VAGINAL DELIVERY: A RANDOMIZED CONTROLLED TRIAL

2020 ◽  
pp. 1-3
Author(s):  
Buranasak Wongsiriphakdee* ◽  
Sukanda Mahawerawat ◽  
Thumwadee Tangsiriwatthana
Keyword(s):  
Vaginal Delivery ◽  
Pulse Rate ◽  
Controlled Trial ◽  
Postpartum Care ◽  
Warm Water ◽  
Perineal Pain ◽  
Control Group ◽  
Study Group ◽  
Analgesic Drug ◽  
Hands And Feet

Objective: To assess the efcacy of immersion hands and feet in warm water for reduce perineal pain after vaginal delivery. Materials and Methods: Postpartum sixty women after vaginal delivery with second degree perineal tear at Khon Kaen hospital from December 2018 to March 2019 were randomized into two groups, the study group received immersion hands and feet in warm water at 6 hours postpartum for ten minutes and standard postpartum care. The control group received only standard postpartum care. The primary outcome was decrease of perineal pain at 6 hours postpartum that measured by visual analogue score (VAS 0 - 100) and secondary outcomes were pulse rate and additional analgesic drug used. Results: After immersion hands and feet in warm water the mean differences of perineal pain measured by VAS score at 6 hours postpartum was signicantly lower in the study group compared with control group (12.2±7.18 vs 3±4.20, p<0.001). Moreover, Pulse rate and additional analgesic drug used within 24 hours were lower in the study group but no statistically signicance. Conclusion: Ten minutes immersion hands and feet in warm water can reduce perineal pain at 6 hours postpartum

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