Role of Tranexamic Acid in Reducing Blood Loss during and after Caesarean Section"

Aim: To find out the efficacy and safety of tranexamic acid (TXA) in reducing blood loss during and after lower segment caesarean section (LSCS). Study Design: A concurrent parallel study Place and Duration of Study: The study was conducted in gynecology and obstetrics department of Kishwar Fazal Teaching Hospital of Amna Inayat Medical College Lahore from April 2019 to January 2020. Methodology: After taking ethical approval from institutional Ethical committee, 84 women undergoing lower segment caesarean section (LSCS) were included in the study. All mothers included in the study were between the age of 20 to 28 years having a body weight in range of 55 to 65 Kg and 145 cm to 160 cm height. Their duration of pregnancy was between38 to 41+6 weeks. Patients were divided into two groups. Each group consisted of 42 women. The injection Tranexamic acid (TXA) was given to one group (TXA group) while other group did not receive any drug (control group). TXA injection was given just before the start of surgery. Blood loss was collected and measured from the time of placental delivery to the end of lower segment cesarean section (LSCS) and then from the end of LSCS to the two hours postpartum. Hemoglobin, haematocrit, urine analysis, liver function tests, renal function were tested in both the groups before and after surgery. Results: Tranexamic acid significantly reduced the quantity of the blood loss from placental delivery to the end of LSCS which was 412.44 +/- 199.2 ml in the TXA group versus 800.22 +/- 306.72 ml in the control group (p<0.001). It also decreased the quantity of blood loss from the end of LSCS to 2 hours postpartum which was 55.7 +/- 43.3 ml in the TXA group versus 63.6 +/- 48.0 ml in the control group (p = 0.188), was not significant. No complications or side effects were noted in either group. Conclusion: Tranexamic acid significantly reduced the amount of blood loss during the LSCS as compare to control group but it did not reduce the blood loss significantly after the caesarean section. Its use was not associated with any side effects or complication like thrombosis. So, TXA can be used safely and effectively in women undergoing LSCS to reduce intra-operative blood loss.