Comparison effect of intravenous tranexamic acid and misoprostol for postpartum haemorrhage

Abstract

Background:Postpartum haemorrhage (PPH) is the third-most common cause of maternal death in the United States and it is still the first prevalent cause of maternal death in developing countries. Active prevention of haemorrhage with an uterotonic or other new drugs leads to a decrease in postpartum vaginal haemorrhage. The aim of this study was to compare anti-haemorrhagic effect of Tranexamic acid (TXA) and Misoprostol for PPH.Patients and Methods:In a double-blinded randomised control clinical trial, 200 women were included after Caesarean or natural vaginal delivery with abnormal PPH. They were divided into two equal intervention and control groups. Effect of intravenous TXA and Misoprostol for postpartum haemorrhage was examined.Results:The mean age of patients was 26.7 ± 6.5 years which ranged from 14 to 43 years. The sonographic gestational age in the group treated with TXA was 37.7 ± 3.4 weeks and it was 37.4 ± 3.3 weeks for the other group (P = 0.44). The haemorrhage in the TXA and Misoprostol groups was 1.2 ± 0.33 litres and 1.18 ± 0.47 litres, respectively (P = 0.79). The haemoglobin levels after 6-12 hours of labour, in TXA group was more than that of the Misoprostol group, but this difference was not statistically significant (P = 0.22 and P = 0.21, respectively).Conclusion:Regarding to the superior results in Misoprostol group in one hand and lack of significant differences between two groups in haemorrhage during labour, post-partum haemoglobin level and discharge haemoglobin level, we can state that Misoprostol has no specific preferences to TXA, but more studies with greater population are needed.

Effect of Intraveous Tranexamic Acid and Sublingual Misoprostol on Reducing Post Cesarean Section Bleeding

“…Sahhaf et al [21] findings contradicting the present study and found that haemoglobin levels and bleeding volume were similar in both misoprostol after 6-12 hours and intravenous TA. The disparity could be attributed to alterations in the sort and dosage of misoprostol managed.…”

Tranexamic acid for the prevention and treatment of postpartum hemorrhage in resource-limited settings: a literature review

“…These findings are supported by another study that revealed that TXA reduced the requirement for additional uterotonic agents compared to the control group, with a rate of (4.2% vs. 7.3%) 30 . In contrast, Misoprostol does not demonstrate any specific preference for TXA 20 .…”

Comparison of intravenous tranexamic acid versus sublingual misoprostol in reducing blood loss in patients undergoing caesarean section-an analytical observational study

“…Sahhaf et al found no significant differences between misoprostol and tranexamic acid group in haemorrhage during labour, postpartum haemoglobin level, and discharge haemoglobin level, and stated that Misoprostol has no specific preferences to TXA. 9 The differences in results may be due to the type and dosage of administered drugs. Bose et al found statistically insignificant reduction in blood loss in the TXA group compared with the misoprostol group, irrespective of the presence or absence of high-risk factors (470.30 vs 491.74 mL, p=0.487).…”

“…Sahhaf et al found no significant differences between misoprostol to TXA and suggested more studies with a greater population. 9 Therefore, this study was designed to evaluate and compare the efficacy of these two therapeutic options in controlling blood loss following CS.…”