Study confirms efficacy of tranexamic acid in PPH management

Postpartum hemorrhage (PPH) contributes to nearly 35% of maternal fatalities worldwide. In 2017, the World Health Organization (WHO) recommended tranexamic acid could be used in the standard comprehensive PPH treatment plan and should be employed in all PPH cases, regardless of its etiology.

A new study aimed to evaluate the efficacy and safety of intravenous (i.v.) tranexamic acid – an antifibrinolytic agent, use for postpartum blood loss reduction after vaginal delivery and lower (uterine) segment Caesarean section (LSCS) and the associated adverse effects with the drug, if any.

This was a randomized, double-blinded, placebo-controlled trial undertaken on mothers who were at high PPH risk and delivered vaginally or via LSCS. The participants were randomized into – a study group (receiving tranexamic acid) and a control group. The drug efficacy (blood loss and PPH incidence) and safety (patients’ vitals and drug-related side effects) were compared among the groups.

The study group exhibited significantly lower mean blood loss from the delivery of placenta to the end of delivery, as well as from the end of delivery to 2 hours postpartum, than the control group. The most common drug-related side effect was nausea (in 16% of the mothers who received the tranexamic acid). At the same time, 9% and 1% of mothers experienced vomiting and diarrhea, respectively.

From the findings, it was concluded that tranexamic acid is effective and safe for the prophylactic management of PPH, irrespective of the cause of PPH. This drug can markedly reduce postpartum blood loss and prevent PPH in cases with vaginal delivery and LSCS. Most drug-related side effects were minor, for instance – nausea, vomiting, and diarrhea, which were not associated with major complications, thromboembolic phenomenon, and maternal or perinatal morbidity and mortality.

Source: Indian Journal of Obstetrics and Gynecology Research. Volume 10, Issue 1, 2023, pages: 21-26