2015
DOI: 10.1002/14651858.cd007872.pub3
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Tranexamic acid for preventing postpartum haemorrhage

Abstract: Tranexamic acid for preventing postpartum haemorrhage.

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Cited by 161 publications
(138 citation statements)
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“…A recent Cochrane systematic review assessing all RCTs using TXA for the prevention of PPH was able to identify 12 studies, all of which were conducted in low-resource and middle-resource settings, with enrolment of less than 1000 parturients. 22 Currently, there has not been a study in the North American setting, and thus recruitment and patient involvement in such a study protocol is unknown. Furthermore, these small-scale RCTs have significant variability in their collection of adverse effects.…”
Section: Tranexamic Acidmentioning
confidence: 99%
“…A recent Cochrane systematic review assessing all RCTs using TXA for the prevention of PPH was able to identify 12 studies, all of which were conducted in low-resource and middle-resource settings, with enrolment of less than 1000 parturients. 22 Currently, there has not been a study in the North American setting, and thus recruitment and patient involvement in such a study protocol is unknown. Furthermore, these small-scale RCTs have significant variability in their collection of adverse effects.…”
Section: Tranexamic Acidmentioning
confidence: 99%
“…The authors performed a meta-analysis of randomised controlled trials (RCTs) comparing the impact of a prophylactic single dose of TXA (mainly 1 g) to placebo or no intervention after vaginal or caesarean delivery, in addition to prophylactic uterotonics 3. Criteria for considering studies for this review, search strategy, data extraction and management, assessment of (1) risk of bias using the Cochrane Collaboration's Risk of Bias Tool, (2) quality of evidence using the Grade approach and (3) heterogeneity, were all clearly described.…”
Section: Methodsmentioning
confidence: 99%
“…Since meta-analyses are only as good as the source data on which they are based, the interpretation of these results should remain cautious 2 4. The authors assert that the studies included were heterogeneous with respect to sample sizes (which range from 74 to 740) and were downgraded to only moderate quality 3. Studies had no long-term follow-up data and were underpowered to assess the safety profile for both the mother (while there is a well-known increased risk of thrombotic events in postpartum women who are in a hypercoagulable state1 2) and the baby (TXA, ie, known to cross the placenta, was administered at least 10 min before the caesarean incision2).…”
Section: Commentarymentioning
confidence: 99%
“…Tranexamic acid Mode of action-Antifibrinolytic which prevents the breakdown of preformed blood clot and therefore stabilises the clot Side effects-Hypotension, diarrhoea, thromboembolic events Recent Cochrane review of 10 randomised controlled trials (RCTs) reported that blood losses >400 mL or >500 mL and >1000 mL were less common in women who received tranexamic acid compared with placebo or no intervention (risk ratios 0.52 (95% confidence interval 0.42 to 0.63) and 0.40 (0.23 to 0.71), respectively) 19 Misoprostol (prostaglandin analogue) 20 Mode of action-Myometrial contraction Side effects-Diarrhoea, rash, dizziness, vomiting 21 Not found to be effective after administration of oxytocin 21 Cochrane review of 11 RCTs concluded that use of carbetocin statistically significantly reduced the need for therapeutic uterotonics (risk ratio 0.62 (0.44 to 0.88) compared with oxytocin for women who underwent caesarean section but not for vaginal delivery. 23 There was no robust evidence to suggest that carbetocin was better than oxytocin in reducing postpartum haemorrhage, and its cost effectiveness remains unclear Syntometrine (combination of 5 units of oxytocin and 0.5 mg of ergometrine)…”
Section: Second Line Drugsmentioning
confidence: 99%