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Role of Tranexamic Acid in Reducing Blood Loss in Vaginal Delivery

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Abstract

Introduction

Anti-fibrinolytic agents are used to reduce obstetric blood loss as the fibrinolytic system is known to get activated after placental delivery.

Objectives

To evaluate the efficacy of parenteral tranexamic acid in reducing blood loss during normal labour and to compare it with the amount of blood loss in patients who received placebo in the third stage of labour.

Methodology

Patients with spontaneous labour or planned for induction of labour and fulfilling the inclusion criteria were recruited for the study. In each patient, the pre-delivery pulse rate, blood pressure, Hb gm% and PCV% were noted. Labour was monitored carefully using a partogram. The study group received Inj. Oxytocin and Inj. Tranexamic acid. The control group received Inj. Oxytocin and Placebo injection. Immediately after delivery of the baby, when all the liquor was drained, the patient was placed over a blood drape—a disposable conical, graduated plastic collection bag. The amount of blood collected in the blood drape was measured. Then the patient was given pre-weighed pads, which were weighed 2 h post-partum. The blood loss was measured by measuring the blood collected in the drape and by weighing the swabs before and after delivery.

Results

The total number of patients studied was 100—equally distributed in both the groups. The age group of the patients and BMI were comparable. There was a significant increase in the pulse rate and decrease in blood pressure in the control group as compared with the study group. The post-delivery haemoglobin and haematocrit were significantly reduced in the control group as compared to the study group. The mean blood loss at the end of 2 h was 105 ml in the study group and 252 ml in the control group. There was a significant increase in the usage of uterotonics and also in the need for blood transfusion in the control group; 12 % of the patients in the control group had to stay for more than 3 days compared to 2 % in the study group.

Conclusion

Tranexamic acid injection, an antifibrinolytic agent when given prophylactically after the delivery of the baby, by intravenous route appears to reduce the blood loss and maternal morbidity during normal labour effectively.

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Authors and Affiliations

  1. Department of Obstetrics and Gynaecology, JSS Medical College and Hospital, Mysore, India

    Priyankur Roy

  2. Department of OBG Unit – II, JSS Medical College and Hospital, JSS University, Mysore, India

    M. S. Sujatha

  3. Department of OBG, JSS Medical College and Hospital, JSS University, Mysore, India

    Ambarisha Bhandiwad

  4. Department of Obstetrics and Gynaecology, King’s Mill Hospital, Sutton in Ashfield, Nottinghamshire, UK

    Bivas Biswas

Authors
  1. Priyankur Roy
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  2. M. S. Sujatha
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  3. Ambarisha Bhandiwad
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  4. Bivas Biswas
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Corresponding author

Correspondence to Priyankur Roy.

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Conflict of interest

There is no conflict of interest involved within the authors of the study.

Ethical Statement

Ethical clearance was obtained from the ethical committee. This study was self-funded and no grants were received in the form of sponsorship.

Informed Consent

Written informed consent has been obtained from all the patients before they were enrolled into the study.

Additional information

Dr. Priyankur Roy is postgraduate student in the Department of Obstetrics and Gynaecology at JSS Medical College and Hospital; Dr. M. S. Sujatha is Professor and Head of the Unit in the Department of OBG Unit II at JSS Medical College and Hospital; Dr. Ambarisha Bhandiwad is Professor and Head of the Department in the Department of OBG, JSS Medical College and Hospital, at JSS University; Dr. Bivas Biswas is Senior Clinical Fellow in the Department of Obstetrics and Gynaecology at King’s Mill Hospital.

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Roy, P., Sujatha, M.S., Bhandiwad, A. et al. Role of Tranexamic Acid in Reducing Blood Loss in Vaginal Delivery. J Obstet Gynecol India 66 (Suppl 1), 246–250 (2016). https://doi.org/10.1007/s13224-016-0856-4

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  • DOI: https://doi.org/10.1007/s13224-016-0856-4

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