Intravenous tranexamic acid use in myomectomy: A prospective randomized double-blind placebo controlled study

Çağlar, Gamze Sinem; Taşçı, Yasemin; Kayıkçıoğlu, Fulya; Haberal, Alı

doi:10.1016/j.ejogrb.2007.04.003

Cited by 74 publications

(55 citation statements)

References 11 publications

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“…There is a variation in dosage of TXA in experimental groups. Three studies [14,16,17] performed general anesthesia and 1 [15] did not give a detailed description. All [14–17] studies reported that open myomectomy was performed by same team.…”

Section: Resultsmentioning

confidence: 99%

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Wang¹,

Wang

et al. 2017

Medicine

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Objective:This meta-analysis aimed to perform a meta-analysis including randomized controlled trials (RCTs) to assess the efficiency and safety of tranexamic acid (TXA) for reducing blood loss and transfusion requirements in patients undergoing open myomectomy.Methods:A systematic search was performed in Medline (1966–2017.03), PubMed (1966–2017.03), Embase (1980–2017.03), ScienceDirect (1985–2017.03,) and the Cochrane Library. Study evaluated the efficiency and safety of TXA in myomectomy was selected. Meta-analysis was performed using Stata 11.0 software.Results:Four RCTs including 328 patients met the inclusion criteria. The present meta-analysis indicated that there were significant differences between groups in terms of total blood loss (standard mean difference [SMD] = −1.512, 95% confidence interval [CI]: −2.746 to −0.278, P = .016), postoperative hemoglobin level (SMD = 0.650, 95% CI: 0.045–1.255, P = .035), transfusion requirements (SMD = −0.102, 95% CI: −0.199 to −0.006, P = .038), and duration of surgery (SMD = −0.514, 95% CI: −0.749 to −0.280, P = .000). In addition, no adverse effect was identified in treatment groups.Conclusions:Intravenous administration of TXA in open myomectomy was associated with significantly reduced total blood loss, postoperative hemoglobin decline, duration of surgery, and transfusion requirements. Based on the limitations of the current meta-analysis, high-quality RCTs with long-term follow-up are still required.

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Section: Resultsmentioning

confidence: 99%

“…All of the RCTs reported a clear inclusion and exclusion criteria and suggest a methodology of randomization; all of them demonstrated that randomization sequence was generated by computer. Three of them [14–16] reported allocate concealment was achieved by sealed envelopes. Double blinding was provided in 3 RCTs.…”

Section: Resultsmentioning

confidence: 99%

Retracted

Wang¹,

Wang

et al. 2017

Medicine

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“…TXA has been used since 1960 in most of the clinical cases whenever anti-fibrinolytic therapy have been appropriate. This is used to reduce haemorrhage and reduce the need for allogeneic blood transfusion especially in cardiac surgeries, liver transplantation and some orthopaedic surgeries with different results 1819202122. Also World Health Organization (WHO) has suggested TXA administration in uncontrollable PPH 81920.…”

Section: Introductionmentioning

confidence: 99%

Comparison effect of intravenous tranexamic acid and misoprostol for postpartum haemorrhage

et al. 2014

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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.

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“…According to the prescribing information the dosage of TXA after cervical conisation should be 3 tablets (1.5 g) three times a day for 12–14 days post operatively [25]; however, administration of TXA is not recommended for benign gynecological interventions, such as myomectomies (2B) [3, 102]. …”

Section: Tranexamic Acid In Elective Applicationsmentioning

confidence: 99%

“…TXA can also be diluted in a drinkable liquid. If the liquid is swallowed after rinsing, the amount has to be allowed for in the overall dose [102]. …”

Section: Tranexamic Acid In Elective Applicationsmentioning

confidence: 99%

Tranexamic acid for treatment and prophylaxis of bleeding and hyperfibrinolysis

Pabinger

Fries

Schöchl

et al. 2017

Wien Klin Wochenschr

137

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SummaryUncontrolled massive bleeding with subsequent derangement of the coagulation system is a major challenge in the management of both surgical and seriously injured patients. Under physiological conditions activators and inhibitors of coagulation regulate the sensitive balance between clot formation and fibrinolysis. In some cases, excessive and diffuse bleeding is caused by systemic activation of fibrinolysis, i. e. hyperfibrinolysis (HF). Uncontrolled HF is associated with a high mortality. Polytrauma patients and those undergoing surgical procedures involving organs rich in plasminogen proactivators (e. g. liver, kidney, pancreas, uterus and prostate gland) are at a high risk for HF. Antifibrinolytics, such as tranexamic acid (TXA) are used for prophylaxis and treatment of bleeding caused by a local or generalized HF as well as other hemorrhagic conditions. TXA is a synthetic lysine analogue that has been available in Austria since 1966. TXA is of utmost importance in the prevention and treatment of traumatic and perioperative bleeding due to the resulting reduction in perioperative blood loss and blood transfusion requirements. The following article presents the different fields of application of TXA with particular respect to indications and dosages, based on a literature search and on current guidelines.

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Intravenous tranexamic acid use in myomectomy: A prospective randomized double-blind placebo controlled study

Cited by 74 publications

References 11 publications

Retracted

Retracted

Comparison effect of intravenous tranexamic acid and misoprostol for postpartum haemorrhage

Tranexamic acid for treatment and prophylaxis of bleeding and hyperfibrinolysis

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