Efficacy of Prophylactic Tranexamic Acid in Preventing Postpartum Hemorrhage after Vaginal Delivery: Evidence from a Randomized Controlled Study

CONTEXT: Postpartum hemorrhage (PPH) is a primary cause of maternal mortality, accounting for 35% of maternal deaths globally. Active management of the third stage of labor (AMTSL) is a prophylactic intervention recommended by the World Health Organization for the prevention of PPH. Antifibrinolytic therapy with tranexamic acid (TXA) offers a potential strategy to minimize blood loss by inhibiting fibrin degradation. AIMS: This study aims to compare the efficacy and safety of parenteral oxytocin with a low dose of TXA versus oxytocin administered within 2 min after vaginal delivery in the prevention of PPH. SUBJECTS AND METHODS: This randomized controlled study was conducted among 488 participants in a tertiary teaching center. Participants were randomly assigned to two groups to compare the effect of injection Oxytocin + injection TXA (1 g) versus injection Oxytocin after vaginal delivery in preventing postpartum hemorrhage. The incidence of PPH, reduction in hemoglobin and hematocrit values, proportion of women requiring supplementary uterotonics treatment, and incidence of postpartum transfusion were assessed. RESULTS: There were no notable differences between the two groups with regard to demographic data. The average expected blood loss is significantly lower among the test (Oxytocin + TXA) group, M = 321.1066, compared to the control (only Oxytocin) group, M = 503.0738, which depicted comparatively higher blood loss. P < 0.01 at 99% confidence interval. Hemoglobin level of the tested groups (M = 12.0545) was found to be comparatively higher than that of the control groups. CONCLUSIONS: The findings of our study indicate that the use of oxytocin with TXA is more effective in preventing PPH and minimizing blood loss compared to oxytocin alone.