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 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 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 The efficiency and efficacy of tranexamic acid in prevention of blood loss during or after caesarean delivery: a comparative study

2020 ◽  
Vol 9 (4) ◽  
pp. 1549
Author(s):  
Supriya Raina ◽  
V. Suguna ◽  
Padmaja Prabraju
Keyword(s):  
Caesarean Section ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Normal Saline ◽  
Test Group ◽  
Normal Vaginal Delivery ◽  
Controlled Study ◽  
Control Group ◽  
Study Group ◽  
Significant Difference

Background: The practice of caesarean section is increasing day by day. Delivery by caesarean section can cause more complications than normal vaginal delivery and one of the most common complications is primary or secondary postpartum hemorrhage. The aim of present study was to study the efficacy and safety of tranexamic acid in reducing blood loss during and after caesarean section.Methods: This study was conducted at Deccan College of Medical Sciences, Hyderabad. It was a prospective randomized double blind placebo controlled study. This study includes 60 pregnant women divided in to two groups. Just before the induction of anesthesia 1 gm of tranexamic acid in 20 ml of normal saline was given over 10 minutes in test group and 20 ml of normal saline was infused in control group.Results: The demographic characters of patients in two groups were comparable. There was no statistically significant difference in the heart rates, respiratory rates and blood pressures in the two groups. There was statistically significant difference in the quantity of the blood loss from during the operation and 2 hours postpartum (p=0.003). Total mean blood loss in control group was 718.80±233.1 ml and in study group was 554.28±207.8 ml. The drop in hemoglobin after caesarean section in study group was not significant where as in control group was significant. There was no significant difference in the prothrombin time and partial thromboplastin time in the groups, pre and post operatively. In this study the use of tranexamic acid reduced the dose of other uterotonics like syntocin in study group.Conclusions: Tranexamic acid significantly reduced the amount of blood loss during the caesarean section and also reduced the use of other uterotonics. Thus, tranexamic acid can be used safely and effectively in subjects undergoing caesarean section.

Efficiency and safety of terlipressin application during caesarian section in pregnant women with a high risk of bleeding: a multicenter comprehensive cohort study of Terli-Bleed. Part I

2021 ◽  
Vol 20 (1) ◽  
pp. 11-20
Author(s):  
Yu.S. Raspopin ◽  
◽  
E.M. Shifman ◽  
A.A. Belinina ◽  
A.V. Rostovtsev ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
High Risk ◽  
Caesarean Section ◽  
Blood Loss ◽  
Pregnant Women ◽  
Postpartum Haemorrhage ◽  
Control Group ◽  
Study Group ◽  
Group I

Prevention of postpartum haemorrhage is one of the important tasks of modern obstetrics, anesthesiology and intensive care. Objective. To assess the efficacy and safety of terlipressin usage as a means of postpartum haemorrhage development prevention during caesarean section in high-risk pregnant women. Patients and methods. From February to December 2020, a multicenter comprehensive cohort study, in which 5 medical centers participated, was conducted. The study included 454 pregnant women who underwent caesarean section and who were divided into two groups: control group I (n = 351) and study group II (n = 103), with the use of terlipressin injected into myometrium. Evaluation of the preventive effect of the drug was carried out in several main directions: the volume of blood loss, the need for additional methods of surgical hemostasis, the safety of intraoperative use. Results. Considerable differences were found in the assessment of significant risk factors for the development of postpartum haemorrhage, associated pathologies and comorbidity between the groups. The study group turned out to be more threatened by the postpartum haemorrhage development. In the control group, additional measures of surgical hemostasis were more often used, including hysterectomy (2.6% versus 1.9%) and relaparotomy (1.9% versus 1%). The median blood loss was statistically lower in the study group (700 ml versus 800 ml). Nevertheless, the considerable spread of data on the volume of blood loss should be noted, with a maximum blood loss of 10,000 ml in the control group and 4,500 ml in the study group. There were no serious complications in both groups. Conclusion. The study showed that the use of terlipressin can reduce the volume of blood loss in women with high risk factors for postpartum haemorrhage, as well as reduce the number of hysterectomies and relaparotomies. It is necessary to continue the prospective part of the study with an increase in the randomized sample of patients. Key words: obstetric haemorrhage, caesarean section, terlipressin

scholarly journals Prophylactic use of tranexamic acid to reduces blood loss and transfusion requirements in caesarean section

2020 ◽  
Vol 9 (7) ◽  
pp. 2987
Author(s):  
Urmila Sunda ◽  
Priyanka Bhadana
Keyword(s):  
Caesarean Section ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Postpartum Haemorrhage ◽  
Tertiary Care ◽  
Control Group ◽  
P Value ◽  
Care Hospital ◽  
Transfusion Requirements ◽  
The Difference

Background: Postpartum haemorrhage (PPH) is most dreaded complication which occurs worldwide, more prevalent in developing countries after both vaginal and caesarean delivery. Prophylactic administration of a uterotonics immediately after delivery is the only procedure that has been proved to reduce rates of postpartum haemorrhage. Tranexamic acid, an antifibrinolytic is recommended by WHO for management of PPH, its role to reduce blood loss in caesarean section as a prophylactic agent is not well studied.Methods: This study was conducted in a tertiary care hospital at New Delhi total 100 pregnant women with age ≥18 and <35 years and singleton alive fetus who underwent caesarean section were included for this study.  Study population was divided in two group. Women assigned to the study group received 1 gm tranexamic acid slowly intravenously over 10 minutes after delivery of the baby as per existing unit protocol. Those women who received tranexamic acid was compared with other group who did not received tranexamic acid. The primary outcomes were mean blood loss (ml) and mean fall in hemoglobin level within 48 hours after surgery.Results: Amount of blood loss was significantly low (mean 369 ml) in tranexamic acid group as compared to control group (488 ml), the difference was statistically significant (p value 0.001).  Mean fall in haemoglobin level was also low (1.17 mg/dl) in group who received tranexamic acid as compared to control group (1.87 mg/dl), the difference was statistically significant (p value 0.001). Postpartum hemorrhage (blood loss more than 1000 ml) was observed in 1 patient in control group and no case of PPH was observed in study group.Conclusions: Tranexamic acid administration prior to caesarean section was effective in reducing the blood loss intra and postoperative period, without any immediate maternal and neonatal adverse events as well as reduces the need of blood transfusion.

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 Comparative study to assess the outcome of omitting bladder flap formation from caesarean delivery

2019 ◽  
Vol 8 (3) ◽  
pp. 882
Author(s):  
Pratiksha Gupta ◽  
Suman Kumari
Keyword(s):  
Caesarean Section ◽  
Blood Loss ◽  
Caesarean Delivery ◽  
Operating Time ◽  
Randomised Control Trial ◽  
Control Group ◽  
Study Group ◽  
Care Hospital ◽  
Total Operating Time ◽  
Formation Step

Background: The aim of this study is to evaluate the effects of omitting the step of bladder flap formation at lower-segment caesarean delivery.Methods: It is a RCT (randomised control trial), non-blinded study conducted in a tertiary care hospital. A total of 104 women who underwent caesarean delivery (elective or emergency) were prospectively randomized to one of the two groups. In the study group (n= 54), caesarean was performed without formation of a bladder flap. In the control group (n=50), caesarean was performed with the formation of a bladder flap before the uterine incision.Results: There were differences of median skin incision to delivery interval (5 versus 6.5 minutes, P <0.0001), median total operating time (35 versus 44.5 minutes, P 0.0002), and median blood loss (haemoglobin 0.5 versus 1g/dl, P 0.0001) in favor of the study group. Postoperative incidence of urinary tract infection was reduced in the study group (1% versus 9%, P <0.0006) and bowel function returned early in the study group (day 2 versus 3, P<0.0001).  Bladder flap formation step was successfully omitted in (11/18, 61.11%) of previous CS (caesarean section) patients in the study group and (7/12, 58.33%) in control group illustrating that unless required, BF (bladder flap) formation step can even be omitted in previous CS patients.Conclusions: Omission of the bladder flap provides short term advantages such as reduction of total operating time, incision-delivery interval, and reduced blood loss and that this technique can even be applied in previous caesarean section patients.

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