The clinical outcome of intravenous single bolus 0.5 gm of tranexamic acid for reducing blood loss following an elective cesarean delivery : a randomized controlled trial

الملخص EN

Objective : to assess the effectiveness and safety of intravenous single bolus 0.5 gm tranexamic acid (TA), compared with 1 gm ta and placebo in reducing blood loss during and after cesarean delivery in women who have at least one risk factor for postpartum hemorrhage (PPH).

subjects and methods : a randomized clinical trial, at a tertiary university hospital between November 1, 2018, and July 30, 2020, ( : NCT 03710330) was conducted on 360 pregnant women at term (37–40 weeks) gestation scheduled for elective cesarean delivery, who were assigned to either 0.5 gm, 1 gm, or, placebo (saline).

the main outcome measures were blood loss at and 6 hours after cesarean delivery, the need for any additional oxytocic drugs, and ta-related side effects.

results : the mean overall blood loss was (609.33 ± 211.5), intraoperative was (465.58 ± 191) and post-operative was (143.75 ± 33.33) in group 2 compared with (829.7 ± 293.3), (665.5 ± 272.2), (165.83 ± 36.59) in group 1 respectively and (751 ± 208.09), (587.75 ± 190.6), (164.08 ± 32.53) in group 3 respectively , so group 2 showed great significant reduction in overall estimated blood loss either intraoperative or post-operative compared with group 1, (p = 0.0001,0.0001,0.0001) and group 3, (p = 0.0001,0.0001,0.0001).

conclusion : both 0.5 gm and 1 gm ta may be more effective than a placebo in reducing total blood loss during and after cd, but 1 gm ta may be more effective than 0,5 gm ta in reducing blood loss during and after cd in women who have a minimum of one risk factor for postpartum hemorrhage, for instance, twin pregnancy, macrosomia, and history of PPH, etc.