The effect of prophylactic use of tranexamic acid for cesarean section

Abstract

Aim

Treatment with tranexamic acid (TxA) significantly reduces maternal death due to postpartum hemorrhage. There is increasing interest in whether it can also be used as prophylaxis for postpartum hemorrhage, especially during cesarean sections (CS). This impact study is aimed to determine the effect of routine prophylactic tranexamic acid during CS on maternal hemorrhage and the rate of the associated side effects.

Methods

This retrospective population-based cohort single-center impact study include 2000 women who delivered by CS divided into two groups with (n = 1000) and without (n = 1000) prophylactic administration of 1gram TxA prior to surgery. Primary outcomes were to determine the: (1) rate of women experiencing >10% or ≥2 g/dL hemoglobin drop from the preoperative concentration within 24 h after CS. (2) incidence of women having a hemoglobin drop of ≥2 g/dL.

Results

Women who did not receive TxA prophylactic had a higher rate of >10% hemoglobin decrease and a higher rate of ≥2 g/dL hemoglobin decrease Than those who received TxA prophylaxis (p < .0001, for both). Mean hospital stay (p = .002) and umbilical cord pH (p < .05) were higher among those who received TxA prophylaxis than in those who were not treated.

Conclusions

The finding of our study suggest that prophylactic administration of TxA prior to CS improves maternal and neonatal outcomes.

Keywords:

• Tranexamic acid
• cesarean section
• post-partum hemorrhage
• hemoglobin
• renal failure
• prophylaxis

Acknowledgment

We would like to thank Mr. Hadar Sharvit for his assistance with the study.

Disclosure statement

No potential conflict of interest was reported by the author(s).