Effect of Prophylactic Intravenous Tranexamic Acid on Blood Loss After Vaginal Delivery: A Randomized Control Study.

Abstract

Background and aim: To determine the effect of prophylactic intravenous tranexamic acid on blood loss after vaginal delivery in women at low risk of postpartum hemorrhage.

Methods: Prospective randomized controlled study (RCT registration: researchregistry10144). Over the study duration of 12 months, a total of 226 parous women with singleton vaginal delivery at term pregnancy with cephalic presentation participated in the study. Participants with pre-existing medical complications and obstetric complications were excluded from the study. Additionally, patients with a previous history of thromboembolism and allergy to tranexamic acid were also excluded from the study. The study participants were divided into two groups based on the intervention considered. This was done with a computer-based random table generator. Group A received an intervention of 10 mL (1 g) of intravenous tranexamic acid while the other group received 10 mL of normal saline as a placebo immediately after delivery of the fetus. Blood loss was calculated by measuring the weights of blood-soaked gauze, gowns, sheets, and tampons before and after delivery. Hemoglobin and hematocrit were done before and 12 h after delivery.

Results: Total number of participants were 226. The mean calculated blood loss and the mean measured blood loss was significantly less in Group A in comparison to Group B (379.17 ± 46.89 mL in Group A and 426.66 ± 58.45 mL in Group B, p < 0.001), (247.88 ± 67.03 mL in Group A and 368.95 ± 58.54 mL in group B, p < 0.001). Similarly, the mean decrease of hemoglobin after delivery was lower for Group A (1.45 ± 0.14) than for Group B (1.74 ± 0.24).

Conclusion: The use of prophylactic intravenous tranexamic acid is associated with reduced blood loss after vaginal delivery. Furthermore, research needs to be done.