Efficacy of tranexamic acid in managing postpartum hemorrhage in normal vaginal delivery in a tertiary care hospital

Background: Postpartum haemorrhage (PPH) is a significant cause of maternal mortality worldwide. Recent studies have shown that the use of tranexamic acid (TXA) in conjunction with Oxytocin has the potential to lead to a substantial reduction in maternal deaths, offering a hopeful prospect for maternal health. However, the frequency of TXA use in India is not well-documented. This study aims to determine whether the prophylactic use of TXA, in addition to Oxytocin, can effectively reduce blood loss during vaginal delivery and improve postpartum care, offering a hopeful prospect for maternal health. Objective: This research will evaluate the impact of TXA combined with Oxytocin compared to Oxytocin alone, focusing on how varying hemodynamic conditions influence management during the third and fourth stages of vaginal birth. It will examine various parameters, including blood loss, haemoglobin levels, and platelet counts. The goal is to assess whether using TXA reduces the occurrence and severity of postpartum haemorrhage, thereby enhancing maternal health outcomes. Methodology: This prospective study, uniquely designed to evaluate the impact of TXA combined with Oxytocin compared to Oxytocin alone, was conducted at SVS Medical College and Hospital, a leading institution in maternal health research. The study included a cohort of eighty women planned for vaginal delivery, randomly assigned to two groups: the treatment group received both Oxytocin and TXA. In contrast, the control group received prophylactic Oxytocin following the Active Management of the Third Stage of Labor (AMTSL) guidelines. The study's inclusion and exclusion criteria were meticulously defined, and vital signs, blood indices, haemoglobin levels, platelet counts, and blood loss were meticulously documented and analysed. Statistical analysis was performed using paired T-tests, with significance established at p< 0.05. Results: The results indicate a significant difference in average blood loss between the TXA group (153 ml) and the control group (171 ml), providing convincing evidence of the efficacy of TXA. The TXA group experienced a slightly smaller average decrease in haemoglobin levels (6.25%) compared to the control group (6.64%), both of which were statistically significant (p< 0.0001). Haemoglobin and platelet counts increased in both groups, with substantial differences observed in pre- and post-delivery measurements (p< 0.001). Adding TXA was associated with reduced blood loss and a less significant drop in haemoglobin levels, indicating a more substantial preventive effect. Conclusion: The addition of TXA to the prophylactic regimen of Oxytocin during vaginal birth significantly reduces blood loss and stabilises haemoglobin levels. This study suggests that TXA is an effective adjunct for preventing PPH, greatly enhancing maternal safety by reducing the risk of severe postpartum haemorrhage. The study's findings provide compelling evidence for the routine use of TXA alongside Oxytocin in actively managing the third stage of labour, particularly in settings where PPH is prevalent. These findings have significant implications for maternal health practices, offering a sense of reassurance and confidence in the potential of TXA to improve maternal outcomes.