Tranexamic acid for cesarean section: a double-blind, placebo-controlled, randomized clinical trial

Şentürk, Mehmet Baki; Çakmak, Yusuf; Yıldız, Gazi; Yildiz, Pınar Özmen

doi:10.1007/s00404-012-2624-8

Cited by 88 publications

(99 citation statements)

References 23 publications

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“…15 A reduction in postoperative bleeding of around 17% at 2 hours was found in the intervention group, which was significantly less than the almost 25% in IV group tranexamic acid and 23% reduction topical tranexamic group in postoperative blood loss found in the present study Aleem A et al in double blind case control trial who conduct their work upon 740 patients and concluded that the use of tranexamic acid before elective cesarean section is associated with reduced post-partum hemorrhage during and pot elective cesarean section. 16 Also, present results were in agreement with Ahmed et al, Movafegh et al, Goswam et al and Senturk et al [20][21][22][23] The topical tranexamic group demonstrated that topical administration of 2 gm of tranexamic acid in in 2000 ml normal saline at placental bed and uterine scar at cesarean delivery reduced intra-and postoperative blood loss, as well as the amount of intraoperative oxytocin used. Hemoglobin level showed a non-significant r decrease in the control group There was no study in the literature address the role of topical tranexamic acid during cesarean section although Two case reports on the use of topical tranexamic acid to control postoperative local bleeding in 2 women with clotting disorders who were undergoing gynecologic procedures.…”

Section: Discussionsupporting

confidence: 82%

Adjunctive IV tranexamic acid versus topical tranexamic acid application of the placental bed for prevention of postpartum hemorrhage in women with placenta previa: a randomized controlled trial

Shady

Sallam

2017

Int J Reprod Contracept Obstet Gynecol

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Background: Placenta previa one of the famous etiology of excessive blood loss during and after cesarean section. The objective of this study was to determine the effect of prophylactic adjunctive IV versus topical tranexamic acid (TA) on calculated and measured blood loss during and after caesarean section due to placenta previa compared with standard IV oxytocin alone.Methods: In this double-blind randomized controlled trial, 120 women were undergoing caesarean delivery for placenta previa (PP) were randomly allocated to receive 10 IU oxytocin IV after placental delivery, or receive 1 gm tranexamic acid IV just before skin incision plus 10 IU oxytocin IV after placental delivery or received 10 IU oxytocin IV after placental delivery plus 2 gm topical tranexamic acid applied on placental bed. The main outcome was to measure blood loss during and 4-hour post caesarean delivery.Results: 120 women were enrolled (n = 40 in each group). Both groups of women received IV tranexamic acid (Group II) and topical tranexamic acid (Group III) showed great reduction in intraoperative and 4 hours post-operative blood loss compared with (Group I) which received 10 IU oxytocin only (P = 0.0001, 0.0001, 0.0001, 0.0001), so the overall estimated blood loss in group II and III showed highly reduction compared with group I (P = 0.0001, 0.0001).Conclusions: Prophylactic adjunctive TA topical application on the placental bed or iv administration reduces blood loss during and after caesarean delivery in women with a placenta previa. novel application of topical tranexamic acid on the placental bed is effective in reduce intraoperative and postoperative bleeding in comparison with IV route with elimination of theoretical risk of thrombi embolism complication with IV rout.

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Section: Discussionsupporting

confidence: 82%

Adjunctive IV tranexamic acid versus topical tranexamic acid application of the placental bed for prevention of postpartum hemorrhage in women with placenta previa: a randomized controlled trial

Shady

Sallam

2017

Int J Reprod Contracept Obstet Gynecol

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“…In another study, Shahid A and Khan A [27] while determining the effectiveness of tranexamic acid (TXA) in reducing blood loss during and after caesarean section (CS), the increased in the risk of thrombosis was not reported. Similar studies by Sentürk MB et al [28] in 220 patients and Gungorduk K et al [29] in 660 patients, the incidence of thromboembolic events were not increased.…”

Section: Discussionsupporting

confidence: 79%

Effect of Intravenous Administration of Tranexamic Acid in Reducing Blood Loss During and After Caesarean Section

Rushulo¹

2016

jmscr

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“…Sentürk et al [32] used TXA 20 cc injected 10 min before the start of CS and found TXA reduced intraoperative and postoperative blood loss without concomitant complications caused by TA such as venous thromboembolism, gastrointestinal problems…”

Section: Resultsmentioning

confidence: 99%

Role of Incisional infiltration with intraperitoneal instillation analgesia in non descent vaginal hysterectomy

Assar

Elmentawy

Mosaad

et al. 2018

Evidence Based Women's Health Journal

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Objective: To evaluate therapeutic yield of tranexamic acid (TXA) injection and fluid co-load on the outcome of cesarean section (CS) conducted under spinal anesthesia Study Design : Prospective randomized comparative study. Patients and Methods:The current included 174 primipara scheduled for elective CS under spinal anesthesia. Intravenous (IV) fluid co-load (15 ml/kg warm lactated ringer solution) started as fast drip during and continued after spinal anesthesia. Patients were randomly allocated into two equal groups: Group TXA received a loading IV dose of 500 mg TXA 20 minutes before surgery followed by continuous TXA infusion at rate of 1 mg/kg/min till end of surgery. Group C did not receive prophylactic TXA, but both groups received a booster dose of 2 gm TXA if required. Patients were monitored for the frequency and severity of hypotension and dose of ephedrine used. Amount of bleeding since skin incision till 2-hours postpartum (PP), the frequency of patients had stopped PP bleeding till 2-hr PP and the total dose of oxytocin drugs and booster doses of TXA were recorded. Results: Hypotension was recorded in 53 patients (30.5%); only 12 patients had blood pressure <80 mmHg. The lowest blood pressure, frequency of hypotension, time of occurrence and duration of hypotension and the used dose of ephedrine showed non-significant difference between both studied groups. The amount of perioperative bleeding was significantly lower in TXA group compared to control group. Twenty parturient had continued PP bleeding for more than 2 hours PP with significantly (p=0.038) lower frequency of bleeders in TXA group. All women had continued bleeding received booster doses of TXA with a significantly higher dose in control group compared to TXA group. Conclusion: Preoperative administration of TXA significantly reduced perioperative bleeding with significant reduction of consumption of TXA booster doses and utrotonics without affecting safety. Fluid coloading allowed reduction of the frequency and extent of hypotension concomitant with spinal anesthesia.

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Tranexamic acid for cesarean section: a double-blind, placebo-controlled, randomized clinical trial

Cited by 88 publications

References 23 publications

Adjunctive IV tranexamic acid versus topical tranexamic acid application of the placental bed for prevention of postpartum hemorrhage in women with placenta previa: a randomized controlled trial

Adjunctive IV tranexamic acid versus topical tranexamic acid application of the placental bed for prevention of postpartum hemorrhage in women with placenta previa: a randomized controlled trial

Effect of Intravenous Administration of Tranexamic Acid in Reducing Blood Loss During and After Caesarean Section

Role of Incisional infiltration with intraperitoneal instillation analgesia in non descent vaginal hysterectomy

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