Tranexamic acid may prevent postpartum haemorrhage
In patients undergoing caesarean section (CS) or vaginal delivery (VD), the intravenous administration of tranexamic acid (TA) appears to be safe and effective in reducing blood loss and the need for blood transfusion. In addition, it may decrease the occurrence of postpartum haemorrhage (PPH) in CS patients, according to a systematic review and meta-analysis.
A total of 25 articles on the use of TA in CS (n=22) or VD (n=3) with 4,747 participants were identified from various online databases and included in the analysis. Compared to control, intravenous TA reduced intraoperative, postoperative and total blood loss by respective mean volumes of 141.25 mL, 36.42 mL and 154.25 mL in CS (p< 0.00001 for all), and 22.88 mL (p= 0.10), 41.24 mL (p<0.00001) and 84.79 mL (p<0.00001) in VD. According to researchers, the efficacy in reducing total blood loss was affected by the mode of delivery after testing for differences between subgroups (p=0.0003).
Moreover, TA reduced the rate of occurrence of PPH in CS (ratio risk [RR], 0.32) and VD (RR, 0.37) and the need for transfusion in CS (RR 0.31). In contrast to blood loss, the mode of delivery did not have any significant effect on the efficacy of TA with regard to PPH occurrence rate and transfusion needs. Thromboembolic events were similar between TA and control groups with an increased risk of minor transient adverse events in TA.Researchers posited that based on available evidence, the use of TA is effective and safe in CS; however, due to the paucity of robust data, a definite conclusion for its use in VD cannot be drawn. High-quality randomized controlled trials with larger samples are thus warranted, said researchers.