Effect of Intravenous Tranexamic Acid in Reducing Blood Loss during and after Elective Caesarean Section in a Third Level Health Institution: A Randomized Controlled Study
Background: Blood loss during caesarean section (C/S) may lead to postpartum
haemorrhage, and is one of the direct causes of maternal mortality and
morbidity globally. Tranexamic acid is recommended in the treatment of
postpartum haemorrhage (PPH) if oxytocin and other utertonics are ineffective
in controlling PPH. In this centre it is not used prophylactically to reduce
blood during caesarean section. Aim: To assess the effect of
prophylactic intravenous tranexamic acid on blood loss during and after
elective C/S at the University of Port Harcourt Teaching Hospital (UPTH). Methods: This was a prospective, single-blind,
randomized, placebo-controlled interventional study conducted at the
Obstetric theatre of UPTH from July 2020 to March 2021. Eligible women were
randomized into two groups; seventy-two women received intravenous tranexamic
acid while seventy-one women received a placebo. Socio-demographic data and the
result of the study were collected through a proforma. Data collected was
analyzed using Statistical Package for Social Sciences (SPSS) Version 22.0. The
results were expressed in tables and charts as frequencies, percentages and
mean. Chi-square test, Fisher’s exact, and T-test were used to determine the
relationship between variables. P-value ≤ 0.05 was considered statistically
significant. Results: The findings showed that tranexamic acid
significantly reduced mean blood loss during and after C/S (p-value < 0.01). The mean total blood loss from C/S to 2 hours post-surgery was significantly lower in the tranexamic acid group (624.88 ± 200.76
ml) in comparison to the placebo group (864.24 ± 229.09 ml), p-value = 0.001.
The mean post-C/S packed cell volume (PCV) was significantly higher among the
tranexamic acid group (30.68% ± 2.80%) in comparison to the placebo group
(28.07% ± 3.27%), t = 5.131, p-value = 0.0001. The maternal side effects were
nausea and vomiting, 9 (12.5%) and 1 (1.4%) participants respectively. Conclusion:
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