Effect of intravenous tranexamic acid administration on blood loss during and after cesarean delivery

Movafegh, Ali; Eslamian, L.; Dorabadi, Azita

doi:10.1016/j.ijgo.2011.07.015

Cited by 118 publications

(129 citation statements)

References 8 publications

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“…Other haematological and biochemical parameters did not have any significant difference in the two groups. These results were comparable with the study by Movafegh et al [6] and Gai et al [7].…”

Section: Discussionsupporting

confidence: 92%

“…Svanberg et al [10] reported 67 cases of abruptio placentae being treated by tranexamic acid without any signs of thrombosis in any. Similar results were found in other studies [6,7,9]. All data demonstrated that tranexamic acid can be used safely without increasing the occurrence of thrombosis, but still more studies are needed in this regard.…”

Section: Discussionsupporting

confidence: 89%

“…Other parameters such as systolic blood pressure, diastolic blood pressure and respiratory rate did not have any significant difference in the two groups. In the study by Movafegh et al [6] and Gai et al [7], there was no significant increase in pulse as also the other post-operative vitals.…”

Section: Discussionmentioning

confidence: 85%

“…Movafegh et al [6] performed their study with intravenous administration of 10 mg/kg of tranexamic acid 20 min before skin incision at caesarean delivery. Mean blood loss was significantly less in the tranexamic acid group compared with the control group for both intra-operative bleeding (262.5 ± 39.6 vs. 404.7 ± 94.4 ml) and post-operative bleeding (67.1 ± 6.5 vs. 141.0 ± 33.9 ml; p \ 0.001), respectively.…”

Section: Discussionmentioning

confidence: 99%

“…It was calculated that 45 subjects would be required per group in order to detect this difference with 80 % power and 5 % probability of type 1 error. Standard deviation was assumed to be 190 for control group and 150 for the test group on the basis of earlier study [6]. Adjusting for 10 % drop out rate, recruitment target was set at 50 subjects per group.…”

Section: Methodsmentioning

confidence: 99%

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Role of Intravenous Tranexamic Acid on Caesarean Blood Loss: A Prospective Randomised Study

Ray

Bhattacharya

Chakraborty

et al. 2016

J Obstet Gynecol India

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Background Post-partum haemorrhage (PPH) is a major cause of maternal mortality globally. Tranexamic acid, an anti-fibrinolytic agent, is a novel approach in an attempt to prevent this dreadful complication. This study aims to document the efficacy of intravenous (IV) tranexamic acid in reducing blood loss during and after caesarean section (CS). Methods In this prospective randomised placebo-controlled open-label study, 100 mothers scheduled for elective CS were randomly selected and divided into two groups (study and control) of 50 each. The study group received 1 g IV tranexamic acid and the control group received IV placebo. Following delivery, all mothers received ten units of oxytocin in 500 ml of normal saline.Results The mean intra-operative and post-partum blood loss were significantly lower in the study group than the control group: 499.11 ± 111.2 and 59.93 ± 12.5 ml versus 690.85 ± 198.41 and 110.06 ± 13.47 ml, respectively, (p \ 0.001). Total blood loss was 30 % less in the study group (p \ 0.001). Six mothers had PPH in the control group, while none in the study group. The difference between the pre-operative and post-operative haemoglobin levels was significantly less in the study group than the control group, 0.26 ± 0.22 versus 0.99 ± 0.48 g% (p \ 0.001).There was no significant difference with respect to other haematological parameters. There was no added adverse effect or need for NICU admission in the study group. Conclusion Pre-operative IV tranexamic acid significantly reduced blood loss during elective CS without any significant adverse effects.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Role of Intravenous Tranexamic Acid on Caesarean Blood Loss: A Prospective Randomised Study

Ray

Bhattacharya

Chakraborty

et al. 2016

J Obstet Gynecol India

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Association of Intravenous Tranexamic Acid With Thromboembolic Events and Mortality

et al. 2021

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IMPORTANCE Tranexamic acid (TXA) is an efficient antifibrinolytic agent; however, concerns remain about the potential adverse effects, particularly vascular occlusive events, that may be associated with its use.OBJECTIVE To examine the association between intravenous TXA and total thromboembolic events (TEs) and mortality in patients of all ages and of any medical disciplines.DATA SOURCE Cochrane Central Register of Controlled Trials and MEDLINE were searched for eligible studies investigating intravenous TXA and postinterventional outcome published between 1976 and 2020.STUDY SELECTION Randomized clinical trials comparing intravenous TXA with placebo/no treatment. The electronic database search yielded a total of 782 studies, and 381 were considered for full-text review. Included studies were published in English, German, French, and Spanish. Studies with only oral or topical tranexamic administration were excluded.DATA EXTRACTION AND SYNTHESIS Meta-analysis, subgroup and sensitivity analysis, and meta-regression were performed. This study followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline. MAIN OUTCOMES AND MEASURES Vascular occlusive events and mortality.RESULTS A total of 216 eligible trials including 125 550 patients were analyzed. Total TEs were found in 1020 (2.1%) in the group receiving TXA and 900 (2.0%) in the control group. This study found no association between TXA and risk for total TEs (risk difference = 0.001; 95% CI, −0.001 to 0.002; P = .49) for venous thrombosis, pulmonary embolism, venous TEs, myocardial infarction or ischemia, and cerebral infarction or ischemia. Sensitivity analysis using the risk ratio as an effect measure with (risk ratio = 1.02; 95% CI, 0.94-1.11; P = .56) and without (risk ratio = 1.03; 95% CI, 0.95-1.12; P = .52) studies with double-zero events revealed robust effect size estimates. Sensitivity analysis with studies judged at low risk for selection bias showed similar results. Administration of TXA was associated with a significant reduction in overall mortality and bleeding mortality but not with nonbleeding mortality. In addition, an increased risk for vascular occlusive events was not found in studies including patients with a history of thromboembolism. Comparison of studies with sample sizes of less than or equal to 99 (risk difference = 0.004; 95% CI, −0.006 to 0.014; P = .40), 100 to 999 (risk difference = 0.004; 95% CI, −0.003 to 0.011; P = .26), and greater than or equal to 1000 (risk difference = −0.001; 95% CI, −0.003 to 0.001; P = .44) showed no association between TXA and incidence of total TEs. Meta-regression of 143 intervention groups showed no association between TXA dosing and risk for venous TEs (risk difference, −0.005; 95% CI, −0.021 to 0.011; P = .53).CONCLUSIONS AND RELEVANCE Findings from this systematic review and meta-analysis of 216 studies suggested that intravenous TXA, irrespective of dosing, is not associated with increased risk of any TE. These results help clarify the incidence of...

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Tranexamic acid for preventing postpartum haemorrhage

Novikova

Hofmeyr

Cluver

2015

Cochrane Database of Systematic Reviews

161

118

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Effect of intravenous tranexamic acid administration on blood loss during and after cesarean delivery

Abstract: Intravenous tranexamic acid decreased intra- and postoperative blood loss and oxytocin administered in patients delivered by cesarean.

Cited by 118 publications

References 8 publications

Role of Intravenous Tranexamic Acid on Caesarean Blood Loss: A Prospective Randomised Study

Role of Intravenous Tranexamic Acid on Caesarean Blood Loss: A Prospective Randomised Study

Association of Intravenous Tranexamic Acid With Thromboembolic Events and Mortality

Tranexamic acid for preventing postpartum haemorrhage

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