Efficacy of Tranexamic Acid to Control of Postpartum Hemorrhage

Abstract

Background: Postpartum haemorrhage (PPH) is a major cause of maternal mortality, accounting for one-quarter of all maternal deaths worldwide. Uterotonics after birth are the only intervention that has been shown to be effective for PPH prevention. Tranexamic acid (TXA), an antifibrinolytic agent, has therefore been investigated as a potentially useful complement to this for both prevention and treatment because its hypothesized mechanism of action in PPH supplements that of uterotonics and because it has been proved to reduce blood loss in elective surgery, bleeding in trauma patients, and menstrual blood loss. objective: The objective of my study was to determine the efficacy of tranexamic acid to control of postpartum hemorrhage. Material and Methods: PPH diagnosis was confirmed by a senior Gynecologist and tranexamic acid (1g) was given to the patient by through IV route over 5min and response was checked clinically. One gram further dose was given to the patient after half hour if bleeding continued. Response was assessed after 4hrs of administration of 1^st dose to determine the efficacy of the drug. Results: Mean age of our study cases was noted to be 28.80 ± 3.72 years. Our study results have indicated that majority of our patients i.e. 103 (65.6 %) were aged equal/less than 30 years of age. Most of our study cases i.e. 103 (65.6%) were from urban areas and 132 (84.1%) belonged to poor families. Mean body mass index of our study cases was 23.67 ± 4.21 kg/m² and obesity was present in 31 (19.7 %). Diabetes was present in 18 (11.5%) of our study cases while pregnancy induced hypertension was noted in 49 (31.2%) of our study cases. Mean parity of our study cases was 4.23 ± 2.37, 109 (69.4%) delivered vaginally while cesarean section deliveries were 30.6 %. Mean blood loss after therapy was 382.14 ± 42.34 ml in our study cases and efficacy noted in 145 (92.4%) of our study cases. Conclusion: Our study results support the use of tranexamic acid in control of primary postpartum hemorrhage as it was found to be effective, safe and reliable. Blood loss was also within acceptable range of less than 500 ml. Efficacy was significantly associated with obesity, diabetes, pregnancy induced hypertension and gestational age.

Keywords: Tranexamic acid, postpartum hemorrhage, efficacy.