Antifibrinolytic therapy with tranexamic acid in pregnancy and postpartum

Peitsidis, Panagiotis; Kadir, Rezan A.

doi:10.1517/14656566.2011.545818

Cited by 116 publications

(127 citation statements)

References 58 publications

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“…The plasma fibrinogen level decreases during the third stage of labour and after placental delivery, and the level of fibrin/fibrinogen degradation products in the serum increases 1 h after child birth and remains raised in the early puerperium [8]. Hence, anti-fibrinolytics will be effective in reducing blood loss by interacting with the fibrinolytic mechanism [8,9].…”

Section: Introductionmentioning

confidence: 99%

Role of Tranexamic Acid in Reducing Blood Loss in Vaginal Delivery

Roy

Sujatha

Bhandiwad

et al. 2016

J Obstet Gynecol India

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Introduction Anti-fibrinolytic agents are used to reduce obstetric blood loss as the fibrinolytic system is known to get activated after placental delivery. Objectives To evaluate the efficacy of parenteral tranexamic acid in reducing blood loss during normal labour and to compare it with the amount of blood loss in patients who received placebo in the third stage of labour. Methodology Patients with spontaneous labour or planned for induction of labour and fulfilling the inclusion criteria were recruited for the study. In each patient, the pre-delivery pulse rate, blood pressure, Hb gm% and PCV% were noted. Labour was monitored carefully using a partogram. The study group received Inj. Oxytocin and Inj. Tranexamic acid. The control group received Inj. Oxytocin and Placebo injection. Immediately after delivery of the baby, when all the liquor was drained, the patient was 123 placed over a blood drape-a disposable conical, graduated plastic collection bag. The amount of blood collected in the blood drape was measured. Then the patient was given preweighed pads, which were weighed 2 h post-partum. The blood loss was measured by measuring the blood collected in the drape and by weighing the swabs before and after delivery. Results The total number of patients studied was 100-equally distributed in both the groups. The age group of the patients and BMI were comparable. There was a significant increase in the pulse rate and decrease in blood pressure in the control group as compared with the study group. The post-delivery haemoglobin and haematocrit were significantly reduced in the control group as compared to the study group. The mean blood loss at the end of 2 h was 105 ml in the study group and 252 ml in the control group. There was a significant increase in the usage of uterotonics and also in the need for blood transfusion in the control group; 12 % of the patients in the control group had to stay for more than 3 days compared to 2 % in the study group. Conclusion Tranexamic acid injection, an antifibrinolytic agent when given prophylactically after the delivery of the baby, by intravenous route appears to reduce the blood loss and maternal morbidity during normal labour effectively.

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Section: Introductionmentioning

confidence: 99%

Role of Tranexamic Acid in Reducing Blood Loss in Vaginal Delivery

Roy

Sujatha

Bhandiwad

et al. 2016

J Obstet Gynecol India

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“…211 Observational studies and case reports have demonstrated the successful use of tranexamic acid in the prevention and treatment of bleeding after vaginal delivery and caesarean section, with reduced amount of blood loss and requirement for transfusion. 71 In some cases, there can be shortening of the bleeding time with DDAVP, 212,213 but the effect is not reliable and it is unlikely to be sufficient as sole therapy in the context of pregnancy. If used, attention should be given to fluid restriction for the ensuing 24 hours (see section 4.9).…”

Section: What Is the Inheritance?mentioning

confidence: 99%

“…[69][70][71] If tranexamic acid is administered at the onset of established labour by intravenous injection, then it is able to exert an antifibrinolytic effect immediately, at the time of placental separation.…”

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Management of Inherited Bleeding Disorders in Pregnancy

2017

BJOG

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“…A recent systematic review suggested that TA reduces the amount of blood loss after delivery and reduces the requirement for blood transfusion [6]. A Cochrane systematic review also concluded that TA decreases blood loss after vaginal and cesarean delivery [7].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Subendometrial and Intramyometrial Blood Flow after Intravenous Tranexamic Acid for Prevention of Postpartum Hemorrhage in Vaginal Delivery: A Randomized Controlled Study

Ismail¹,

Abbas²,

Shahat³

et al. 2017

J Gynecol Res Obstet

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Objective: The study aims to test the effect of tranexamic acid (TA) on uterine vasculature and blood loss after vaginal delivery. Materials and methods:A randomized, double-blind, placebo-controlled trial, conducted in Assiut Woman's Health Hospital, Egypt between the 1st of October 2015 and the 31st of March 2016 included pregnant women (37-42 weeks) with a single living cephalic fetus. The eligible women were randomized to receive TA or placebo after vaginal delivery. Doppler indices were measured for the subendometrial, intramyometrial and uterine blood vessels two hours after delivery. The main study outcome was the effect of TA on subendometrial and intramyometrial blood fl ow. Results:Two hundred women were enrolled (n=100 in each group). There was a signifi cant increase in the Doppler indices of subendometrial and intramyometrial blood vessels with no difference in indices in uterine arteries between both groups. The mean of estimated blood loss decreased signifi cantly in TA group (p<0.001). The haematocrit and hemoglobin levels were higher in TA group than the placebo group after delivery (p<0.001). Conclusions:The use of intravenous TA after vaginal delivery increases the resistance in the subendometrial and intramyometrial blood vessels and reduces postpartum hemorrhage.

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Antifibrinolytic therapy with tranexamic acid in pregnancy and postpartum

Cited by 116 publications

References 58 publications

Role of Tranexamic Acid in Reducing Blood Loss in Vaginal Delivery

Role of Tranexamic Acid in Reducing Blood Loss in Vaginal Delivery

Management of Inherited Bleeding Disorders in Pregnancy

Evaluation of Subendometrial and Intramyometrial Blood Flow after Intravenous Tranexamic Acid for Prevention of Postpartum Hemorrhage in Vaginal Delivery: A Randomized Controlled Study

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