Effect of tranexamic acid in reducing blood loss during and after cesarean delivery

Objective The aim was to evaluate the effect of tranexamic acid (TA) in reducing blood loss during and after elective cesarean delivery (CS). Background Postpartum hemorrhage is an obstetrical emergency that can follow delivery. It is a major cause of maternal sickness and maternal death. Patients and methods In all, 74 full-term pregnant primigravida with singleton pregnancy aged between 20 and 35 years, scheduled for elective CS were enrolled at a prospective study. The patients were divided into two groups. Group I: patients received a bolus injection of 1 g of intravenous TA diluted in 20 ml of 5% dextrose solution slowly over 5 min at 10 min before skin incision. Oxytocin 10 units in 500 ml normal saline (9% saline) intravenous drip (8 ml/min) were administrated after fetal delivery. Group II: no TA was given; oxytocin was administered as in group I. Preoperatively, complete blood picture and coagulation profile were done. Result Hemoglobin and hematocrit levels decreased significantly in group II than in group I (P = 0.007; 0.005) consecutively. On comparing the two studied groups, there was a significant decrease in the amount of blood loss in group I than in group II (P = 0.001). More cases in group II than in the TA group required further ecbolic treatment during the postoperative period (P = 0.018). Conclusion A safe dose of TA plays an effective role in reducing blood loss during lower segment CS without causing complications.