Role of tranexamic acid in reducing blood loss in vaginal delivery
DOI:
https://doi.org/10.18203/2320-6012.ijrms20244108Keywords:
PPH, TXA, Vaginal delivery, Blood loss reductionAbstract
Background: Postpartum hemorrhage (PPH) remains a significant reason for maternal death, especially in developing nations like India, where it accounts for 23% of maternal deaths. This prospective study aimed to assess the effectiveness of tranexamic acid (TXA) in reduction of blood loss during vaginal deliveries.
Methods: This study was conducted at Bebe Nanki mother and child care centre in Amritsar, Punjab. 200 pregnant women were randomly assigned to two groups: Group A received 1g TXA intravenously alongside 10 IU oxytocin intramuscularly, while group B received only oxytocin. The measurement of blood loss was done up to 2 hours post-delivery along with various vital and hemodynamic parameters.
Results: The results showed reduction in blood loss in group A in comparison to Group B which was significant, with mean blood loss of 106.25 mL in group A vs 222.45 mL in group B (p=0.001). Hb and PCV declines were also significantly lower in group A. Fewer patients in group A required additional uterotonics (4%) or blood transfusions (2%) versus group B (26% and 4%, respectively). No significant adverse effects, such as thromboembolic events, were observed in either group. Mild post-delivery nausea and vomiting was seen in both groups, with slightly higher incidence in group A.
Conclusions: TXA combined with oxytocin significantly reduces postpartum blood loss without major side effects, supporting its use as an adjunct therapy in PPH management. Further studies are recommended to validate these findings and promote wider adoption in clinical practice.
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References
Benzies K, Tough S, Tofflemire K, Frick C, Faber A, Newburn‐Cook C. Factors influencing women’s decisions about timing of motherhood. J Obstetr Gynecol Neonatal Nursing. 2006;35(5):625-33.
Sandall J, Tribe RM, Avery L, Mola G, Visser GH, Homer CS, et al. Short-term and long-term effects of caesarean section on the health of women and children. The Lancet. 2018;392(10155):1349-57.
Ngwenya S. Postpartum hemorrhage: incidence, risk factors, and outcomes in a low-resource setting. Int J Women's Health. 2016;2:647-50.
Ekin A, Gezer C, Solmaz U, Taner CE, Dogan A, Ozeren M. Predictors of severity in primary postpartum hemorrhage. Arch Gynecol Obstet. 2015;292:1247-54.
AbouZahr C. Global burden of maternal death and disability. Brit Med Bull. 2003;67(1):1.
Mahendra G, Babu R, Kumari A, Pukale RS. Postpartum haemorrhage: various method of management in a rural tertiary care hospital. Obs Gyne Rev J Obstet Gynecol. 2019;5:93-8.
Nigam A, Prakash A, Saxena P. Blood transfusion in obstetrics. Kathmandu Uni Med J. 2013;11(4):355-9.
Tengborn L, Blombäck M, Berntorp E. Tranexamic acid–an old drug still going strong and making a revival. Thromb Res. 2015;135(2):231-42.
Ducloy-Bouthors A, Broisin F, Keita H, Fontaine S, Depret S, Legoeff F, et al. Tranexamic acid reduces blood loss in postpartum haemorrhage. Crit Care. 2010;14:1-2.
Dahiya K. Efficacy and safety of tranexamic acid in the prevention of postpartum haemorrhage after vaginal delivery. Int J Clin Obstet Gynaecol. 2021;5(3):377-81.
Devi VC, Sangeetha V, Devi KA. A role of tranexamic acid in reducing blood loss in normal labour. Int J Acad Med Pharm. 2023;5(4):306-12.
Ali MM, El-Bromboly WH, Elnagar WM, Abou Hashem MF. Prevention of postpartum hemorrhage after vaginal delivery using tranexamic acid. The Egypt J Hosp Med. 2021;85(1):2937-40.
Nivedhana AP, Indu NR, Jalakandan B. Does prophylactic tranexamic acid reduce blood loss in Indian women following vaginal delivery? Int J Reprod Contracept Obstet Gynecol. 2021;10(2):497-505.
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