Prophylactic Use of Tranexamic Acid on Blood Loss in Cesarean Delivery: A Randomized Controlled- Clinical Trial

Background: Post-partum haemorrhage (PPH) is a major cause of maternal mortality worldwide. Tranexamic acid, an anti-fibrinolytic agent, is a novel approach in an attempt to prevent this dreadful complication. Objective: This study aimed to evaluate the efficacy and safety of tranexamic acid in reducing blood loss during and after cesarean section (CS). Methods: In this prospective randomized placebo-controlled clinical trial, 50 pregnant women were randomized into two groups. In the study group, 25 women received tranexamic acid 10 minutes before CS, whereas in the control group 25 women received distilled water. Blood was collected during two periods. The first time was from placental delivery to the end of CS and the second was from the end of CS to 2 h postpartum. The volume of blood was measured and compared between the two groups. Results: Tranexamic acid significantly reduced the quantity of blood from the end of CS to 2 h postpartum, which was 65.15±31.97 mL and 101.14±44.94 mL in the study and control groups, respectively (P =0.002). It also significantly reduced the volume of total blood from placental delivery to 2 h postpartum, which was 616.32±176.87 mL and 731.45±178.79 mL in the study and control groups (P =0.028). Total blood loss in the study group was 18.7% less than the control group. No complications or side effects were reported in the groups. Conclusions: Tranexamic acid statistically reduces the volume of blood loss from placental delivery to 2 h postpartum and its use was not associated with any side effects or complications. Therefore, tranexamic acid can be used as a safe and effective approach to reducing bleeding resulting from CS.