"The Efficacy of Prophylactic Tranexamic   Acid in Reducing Perioperative Blood Loss  During Caesarean Section: A Randomized, Double  Blind Control Trial"

Background In this meta-analysis, we aimed to update the clinical evidence regarding the efficacy and safety of TXA in the prevention of PPH. Methods A literature search of PubMed, Scopus, Web of Science, Google Scholar, and Cochrane Library from inception until December 2022 was conducted. We included randomized controlled trials (RCTs) comparing TXA with a placebo among pregnant women. All relevant outcomes, such as total blood loss, the occurrence of nausea and/or vomiting, and changes in hemoglobin, were combined as odds ratios (OR) or mean differences (MD) in the meta-analysis models using STATA 17 MP. Results We included 59 RCTs (18,649 patients) in this meta-analysis. For cesarean birth, TXA was favored over the placebo in reducing total blood loss (MD= -2.11 mL, 95%CI [-3.09 to -1.14], P < 0.001), and occurrence of nausea or/and vomiting (OR = 1.36, 95%CI [1.07 to 1.74], P = 0.01). For vaginal birth, the prophylactic use of TXA was associated with lower total blood loss, and higher occurrence of nausea and/or vomiting (MD= -0.89 mL, 95%CI [-1.47 to -0.31], OR = 2.36, 95%CI [1.32 to 4.21], P = 0.02), respectively. However, there were no differences between the groups in changes in hemoglobin during vaginal birth (MD = 0.20 g/dl, 95%CI [-0.07 to 0.48], P = 0.15). The overall risk of bias among the included studies varies from low to high risk of bias using ROB-II tool for RCTs. Conclusions This meta-analysis suggested that TXA administration is effective among women undergoing cesarean birth or vaginal birth in lowering total blood loss and limiting the occurrence of PPH. Further clinical trials are recommended to test its efficacy on high-risk populations.

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"The Efficacy of Prophylactic Tranexamic Acid in Reducing Perioperative Blood Loss During Caesarean Section: A Randomized, Double Blind Control Trial"

Abstract: Postpartum haemorrhage (PPH) is a potential life-threatening complication of both vaginal and Caesarean deliveries [4]. It is reported that PPH accounts for nearly 25% of maternal deaths

Cited by 3 publications

References 18 publications

Use of tranexamic acid in decreasing blood loss during and after delivery among women in Africa: a systematic review and meta-analysis

Use of tranexamic acid in decreasing blood loss during and after delivery among women in Africa: a systematic review and meta-analysis

Meta-analysis: the prophylactic use of tranexamic acid to reduce blood loss during caesarean delivery

Efficacy and safety of tranexamic acid in prevention of postpartum hemorrhage: a systematic review and meta-analysis of 18,649 patients

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