EFFICACY AND SAFETY OF TRANEXAMIC ACID IN REDUCING BLOOD LOSS DURING AND AFTER CAESAREAN SECTION

DR.DEVIKA PERUMAL; DR.KALPANA SIVARAMAN

Volume : VI, Issue : V, May - 2017

EFFICACY AND SAFETY OF TRANEXAMIC ACID IN REDUCING BLOOD LOSS DURING AND AFTER CAESAREAN SECTION

Dr. Devika Perumal, Dr. Kalpana Sivaraman

Abstract :

BACKROUND: Caesarean section rates have increased to as high as 25 to 30% in many areas of the world. Delivery by caesarean section can cause more complications than normal vaginal delivery and one of the most common complications is primary and secondary post partum haemorrhage. Tranexamic acid is a synthetic derivative of the amino acid lysine, it exerts antifiinolytic effect through the reversible blockade of the lysine binding residues on plasminogen molecules. Tranexamic acid has been shown to be very useful in reducing blood loss and incidence of blood transfusion in many surgeries, and it is also cost effective. OBJECTIVE(S): To study the efficacy and safety of preoperative intravenous tranexamic acid in reducing blood loss during and after caesarean section. METHOD(S): A randomized case controlled prospective study was conducted on 300 women undergoing lower segment caesarean section(LSCS).One fifty of them were given intravenous tranexamic acid 20 minutes prior to LSCS compared with 150 others to whom tranexamic acid was not given. Blood loss was collected and measured during two periods. The first period was from placental delivery to end of LSCS and 2nd from end of LSCS to2hours postpartum. Vital signs at the time of delivery, at the time of placental delivery, 1hr,&2hrs postpartum and apgar score were studied in both the groups. Post operatively haemoglobin, and haematocrit were tested in both the groups. RESULTS: Tranexamic acid significantly reduced the amount of blood loss from end of LSCS to 2hrs postpartum 74.28ml in the study group compared to114.48ml in the control group(P=0.001). It also significantly reduced the amount of blood loss from the time of placental delivery to end of LSCS379.66ml in the study group versus 485.45ml in the control group (P=0.001).The fall of postoperative haemoglobin and haematocrit was significantly reduced in study group(1gm/dl) versus (1.551gm/dl) in control group. No side effects or no adverse perinatal outcome was noted in either group. CONCLUSION(S): Tranexamic acid significantly reduced the amount of blood loss during and after caesarean section and its use was not associated with any side effects or complications like thrombosis. Further studies are necessary to evaluate its efficacy in pregnancies at high risk for PPH.