Tranexamic acid, as an adjunct to oxytocin prophylaxis, in the prevention of postpartum haemorrhage in women undergoing elective caesarean section: A single‐centre double‐blind randomised controlled trial

Lee, Shi Hui; Kwek, Michelle E-Jyn; Sunkara, Tagore; Wright, Ann; Ku, Chee Wai; Teong, Aimee Chuin Ai; Tan, Amanda Wei Mun; Sultana, Rehena; Mathur, Deepak; Mathur, Manisha

doi:10.1111/1471-0528.17445

Cited by 10 publications

(4 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In this study, intraoperative blood loss and total blood loss differed significantly between the two groups (W = 267.500, P = 0.001), whereas postoperative blood loss did not show a significant difference ( t = −1.468, P = 0.147). Similar results have been reported in other RCTs as well[ 13 15 16 17 18 20 ] and also corroborated with the Tranexamic Acid for Preventing Postpartum Hemorrhage Following a Cesarean Delivery (TRAAP2) trial results, where 4431 women undergoing elective and emergency CS were randomized to receive prophylactic TXA or placebo. [ 21 ] The significance of TXA in reducing intraoperative blood loss in low-risk women undergoing CS was found in a recent systematic review that evaluated 15 RCTs.…”

Section: Discussionsupporting

confidence: 85%

“…[ 19 ] and Lee et al . [ 20 ] However, contradictory results were reported by Lakshmi et al ,[ 15 ] who found that 20 IU of oxytocin was required in nine participants in the case group and three participants in the control group ( P < 0.05).…”

Section: Discussionmentioning

confidence: 94%

“…In RCTs conducted by Sahu et al ,[ 11 ] Sekhavat et al ,[ 12 ] Movafegh et al ,[ 13 ] Goswami et al ,[ 14 ] Lakshmi et al ,[ 15 ] Ray et al ,[ 16 ] Medhi et al ,[ 17 ] Oseni et al ,[ 18 ] Iqbal et al ,[ 19 ] and Lee et al ,[ 20 ] both groups were matched for demographic analysis.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, neonates in neither group required any resuscitation, which is consistent with the results of other studies. [ 11 12 13 14 15 16 17 18 19 20 ]…”

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Role of prophylactic tranexamic acid in reducing blood loss during cesarean section: A double-blind placebo-controlled randomized controlled trial

Sinha,

Rajbhar,

Thakur

et al. 2024

Journal of Family Medicine and Primary Care

View full text Add to dashboard Cite

Background: Postpartum hemorrhage (PPH) is defined by the World Health Organization as blood loss of ≥500 mL within 24 h of delivery. Globally, hemorrhage accounts for 27.1% of maternal deaths, making it the leading direct cause of maternal death. PPH has been identified in more than two-thirds of reported hemorrhage-related deaths, causing 38% of maternal deaths in India. Tranexamic acid, an antifibrinolytic, has been used to control bleeding after PPH is identified. Materials and Methods: Antenatal women admitted for elective cesarean section were randomized into two arms: the case group (received one gram of tranexamic acid 20 min prior to skin incision) and the control group (received a placebo), each group consisting of 36 participants. Clinical Trials Registry – India (CTRI) registration number – CTRI/2021/02/031579. Results: The mean (±standard deviation [SD]) intraoperative blood loss in the case group was 241.25 (±67.83) mL, and in the control group, it was 344.92 (±146.67) mL (P = 0.001), while postoperative blood loss did not differ significantly between the groups (P = 0.1470). In terms of the difference in hemoglobin, there was a significant difference between the two groups (P = 0.001). No significant maternal or neonatal side effects were found. Conclusion: Preoperative tranexamic acid, when given in elective cesarean section, significantly reduces intraoperative blood loss.

show abstract

Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

“…In addition, neonates in neither group required any resuscitation, which is consistent with the results of other studies. [ 11 12 13 14 15 16 17 18 19 20 ]…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Role of prophylactic tranexamic acid in reducing blood loss during cesarean section: A double-blind placebo-controlled randomized controlled trial

Sinha,

Rajbhar,

Thakur

et al. 2024

Journal of Family Medicine and Primary Care

View full text Add to dashboard Cite

show abstract

Tranexamic acid for preventing postpartum haemorrhage after caesarean section

Rohwer,

Cluver

et al. 2024

Cochrane Database of Systematic Reviews

View full text Add to dashboard Cite

Rationale Postpartum haemorrhage (PPH) is common and potentially life‐threatening. The antifibrinolytic drug tranexamic acid (TXA) is recommended for treating PPH; it reduces the risk of death from haemorrhage by one‐third when given soon after bleeding onset, but not overall risk of death. Interest in whether TXA may be effective in preventing PPH is growing. Evidence indicates that TXA given more than three hours after injury to bleeding trauma patients increases mortality. Potential harm becomes critical in prophylactic use of TXA. Reliable evidence of the effect and safety profile of TXA is required before widespread prophylactic use can be considered. Objectives To assess the effects of TXA for preventing PPH compared to placebo or no treatment (with or without uterotonic co‐treatment) in women during caesarean birth. Search methods We searched CENTRAL, MEDLINE, Embase, and WHO ICTRP to 20 February 2024 and searched reference lists of retrieved studies. Eligibility criteria We included randomised controlled trials (RCTs) evaluating the use of TXA alone or plus uterotonics during caesarean birth for preventing PPH. Trials needed to be prospectively registered (i.e. before starting recruitment). We applied a trustworthiness checklist. Outcomes The critical outcome was blood loss ≥ 1000 mL, measured using estimated or calculated methods. Important outcomes included maternal death, severe morbidity, blood transfusion, the use of additional surgical interventions to control PPH, thromboembolic events, use of additional uterotonics, hysterectomy, maternal satisfaction, and breastfeeding at discharge. Risk of bias We assessed risk of bias in the included studies using Cochrane's RoB 1 tool. Synthesis methods Two review authors independently selected trials, extracted data, and assessed risk of bias and trial trustworthiness. We pooled data using random‐effects meta‐analysis. We assessed the certainty of the evidence using GRADE. Included studies We included six RCTs with 15,981 participants. All 12 trials in the previous version of this review were not included after review of trial registrations and trustworthiness checklists. Most included studies involved women at low risk of PPH and were conducted in high‐resource settings. Synthesis of results Prophylactic TXA in addition to standard care compared to placebo in addition to standard care or standard care alone TXA results in little to no difference in estimated blood loss ≥ 1000 mL (risk ratio (RR) 0.94, 95% confidence interval (CI) 0.79 to 1.11; 4 RCTs; n = 13,042; high certainty evidence), resulting in 8 fewer per 1000 women having estimated blood loss ≥ 1000 mL (from 30 fewer to 16 more). TXA likely results in a slight reduction in calculated blood loss ≥ 1000 mL (RR 0...

show abstract

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

Guinness,

Hanley,

Spring

2024

Ir J Med Sci

View full text Add to dashboard Cite

Tranexamic acid, as an adjunct to oxytocin prophylaxis, in the prevention of postpartum haemorrhage in women undergoing elective caesarean section: A single‐centre double‐blind randomised controlled trial

Abstract: This trial was registered with Clini calTr ials.gov (trial registration number NCT04427618).

Cited by 10 publications

References 35 publications

Role of prophylactic tranexamic acid in reducing blood loss during cesarean section: A double-blind placebo-controlled randomized controlled trial

Role of prophylactic tranexamic acid in reducing blood loss during cesarean section: A double-blind placebo-controlled randomized controlled trial

Tranexamic acid for preventing postpartum haemorrhage after caesarean section

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

Contact Info

Product

Resources

About