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Effectiveness of Tranexamic acid on blood loss in patients undergoing elective cesarean section: Randomized clinical trial

The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians | 12 Apr 2013

H Abdel-Aleem, T Alhusaini, M Abdel-Aleem, M Menoufy and A Gülmezoglu
Abstract
Abstract Objective: Cesarean section is associated with more blood loss than vaginal delivery. This could increase the risk of morbidity and mortality especially among anemic women.The objective of the trial is to assess the possible effect of tranexamic acid on blood loss during and after elective cesarean section. Methods: We conducted a randomized controlled trial at Women’s Health Hospital, Assiut University, Assiut, Egypt. All pregnant women with singleton fetus planned to have elective cesarean section at ≥37wks gestation were randomized to receive 1 gm tranexamic acid slowly intravenously over10 minutes before elective cesarean section group or not.Blood loss was measured during and for two hours after operation. Any side effects, complications, medications, changes in vital signs and duration of hospital stay were recorded. This study is registered, number ACTRN12612000313831 Results: Seven hundred and forty women were randomized (373in study group and 367 in control group). Mean total blood loss was 241.6 (SE 6.77) ml in the tranexamic acid group versus 510 (SE 7.72) ml in the control group. The mean drop in hematocrit and hemoglobin levels werestatistically significantly lower in the tranexamic acidgroup than in the control group. There were no statistically or clinically significant differences in other outcomes. Conclusions: Pre-operative use of tranexamic acid is associated with reduced blood loss during and after elective cesarean section.This could be of benefit for anemic women or those who refuse blood transfusion.
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Concepts
Blood transfusion, Epidemiology, Pharmacology, Effectiveness, Randomized controlled trial, Clinical trial, Blood, Childbirth
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