Effect of intravenous tranexamic acid on blood loss reduction during and after caesarean section: a randomised controlled study

Primary postpartum haemorrhage is one of the leading causes of maternal mortality and morbidity. This has led to different modalities and actions being instituted to reduce hemorrhage after childbirth. The need to explore other interventions for reduction of blood loss, aside from the use of oxytocics have arisen. Tranexamic acid is an antifibrinolytic agent which has been approved for treating postpartum haemorrhage. The study determined the effectiveness of tranexamic acid in reducing blood loss during and after Caesarean section The study was a double blind randomized controlled study on blood loss reduction following administration of 1g of intravenous tranexamic acid on women who underwent Caesarean section at University of Abuja Teaching Hospital. Statistical Product and service production (SPSS) software version 24 was used to analyze the data. A p value of < 0.05 was considered to be statistically significant The mean postoperative haemoglobin concentration was 9.70 ±0.86g/l and 10.50 ±0.90g/l in placebo and tranexamic acid group respectively. This was statistically significant (a p value <0.0001). The mean change (reduction) in haemoglobin concentration was significantly lower in tranexamic acid group 0.49 ±0.48g/l with 1.15 ±0.16g/l in the placebo. There was also significant reduction in mean change in haematocrit in tranexamic group, 1.06 ±3.4% compared to 4.16 ±3.98% in placebo group. The average blood loss in tranexamic group was 725.1 ±277.9mls compared to 1183.02 ±325.9mls in placebo group. This represented 457.92mls reduction in blood loss in those treated with preoperative intravenous tranexamic acid (p =0.045). This was statistically significant. Similarly, the need for additional uterotonics was significant in the placebo group when compared with the study group. The mean duration of surgery and the need for blood transfusion was not statistically significant. There was no difference in the fetal outcomes for both group This study demonstrated that the use of preoperative tranexamic acid reduced blood loss and need for additional uterotonics during Caesarean Section. Post operatively it significantly reduced decrease in haemoglobin and haematocrit concentration thereby preventing postpartum anemia PACTR202406748563034