Safety and efficacy of preoperative tranexamic acid in reducing intraoperative and postoperative blood loss in high-risk women undergoing cesarean delivery: a randomized controlled trial

Mohamed A Shalaby, Ahmed M Maged, Amira Al-Asmar, Mohamed El Mahy, Maged Al-Mohamady, Nancy Mohamed Ali Rund, Mohamed A Shalaby, Ahmed M Maged, Amira Al-Asmar, Mohamed El Mahy, Maged Al-Mohamady, Nancy Mohamed Ali Rund

Abstract

Background: Objective to assess the value of preoperative tranexamic acid (TXA) in reduction of intraoperative and postoperative blood loss in high-risk cesarean delivery (CD).

Methods: A double blind randomized controlled trial included 160 high risk women who underwent elective lower segment CD. They were equally randomized to receive either 1 g of TXA or placebo 15 min before surgery. The primary outcome was Intraoperative blood loss.

Results: The estimated blood loss was significantly higher in the placebo group when compared to TXA group (896.81 ± 519.6 vs. 583.23 ± 379.62 ml, P < 0.001). Both postoperative hemoglobin and hematocrit were lower (9.2 ± 1.6 and 27.4 ± 4.1 vs. 10.1 ± 1.2 and 30.1 ± 3.4, P values < 0.001and 0.012 respectively) and their change percentages (15.41 vs. 7.11%, P < 0.001) were higher in the placebo group when compared to TXA one. The need for further ecbolics was higher in placebo group when compared to TXA group (46.25 vs. 13.75%, P < 0.001).

Conclusion: Preoperative TXA is safe and effective in reducing blood loss during and after high-risk CD.

Trial registration: ClincalTrial.gov ID: NCT03820206 .

Keywords: Elective CS; High risk CS; Intraoperative blood loss; Postpartum hemorrhage; Tranexamic acid.

Conflict of interest statement

All authors report that there is no competing interests in this work.

© 2022. The Author(s).

Figures

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Fig. 1
Consort flow chart

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Source: PubMed

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