Efficacy and Safety of Preoperative Intravenous Tranexamic Acid to Reduce Blood Loss During and After Elective Lower‐Segment Cesarean Delivery

Abstract

Aim: This work aimed to study the efficacy and safety of preoperative intravenous tranexamic acid to reduce blood loss during and after elective lower‐segment cesarean delivery.Materials and Methods: A double‐blind, randomized placebo‐controlled study was undertaken of women undergoing elective lower‐segment cesarean delivery of a full‐term singleton pregnancy at a center in tertiary referral hospital , Egypt, between December, 2019 and March, 2020. Patients were randomly assigned (1:1) using computer‐generated random numbers to receive either 1 g tranexamic acid(TXA) or 5% glucose 15 minutes before surgery. Preoperative and postoperative complete blood count, hematocrit values, and maternal weight were used to calculate the estimated blood loss (EBL) during cesarean section, which was the primary outcome. Analyses included women who received their assigned treatment, whose surgery was 90 minutes or less, and who completed follow‐up.Results: Eighty women in each group.There was no statistical difference found between women subjected to TXA and those subjected to placebo regarding maternal age, weight, gestational age or mode of previous delivery. Mean EBL was significantly higher in the placebo group (896.81 ± 519.6mL mL) than in the tranexamic acid group (583.23 ± 379.62mL; P < 0.001).Conclusion: Preoperative administration of tranexamic acid safely reduces blood loss during elective lower‐segment cesarean delivery