Tranexamic acid reduces blood loss during and after cesarean section: A double blinded,randomized, controlled trial

ObjectiveTo evaluate the efficacy of tranexamic acid in reduction of blood loss during and after cesarean section.MethodsWomen included in the current double blinded, randomized, controlled trial were recruited from women attending for elective cesarean section and randomized into two groups; study group: received tranexamic acid with induction of anesthesia plus 10 IU of oxytocin injection after delivery of the baby. Control group: received only oxytocin 10 IU injection after delivery of the baby.ResultsTwenty four hours post-operative hemoglobin level was significantly higher in study group (11.2 ± 1.5 mg/dL) compared to control (9.6 ± 1.2 mg/dL), also 24 hours post-operative hematocrit was significantly higher in study group (30.2 ± 6.6) compared to control (29.2 ± 2.8). Calculated total blood loss from placental delivery till end of cesarean section was significantly less in study group compared to control (369.5 ± 198.0 versus 606.8 ± 193.0 mL; respectively), also, calculated vaginal bleeding during first 6 hours post-operative was significantly less in study group compared to control (85.0 ± 30.7 mL versus130.8 ± 49.3 mL, respectively). The incidence of post-partum hemorrhage was significantly less in study group compared to control (31.1% versus 63.2%; respectively), also the need for iron replacement therapy was significantly less frequent in study group compared to control (0.9% versus 6.6%, respectively).ConclusionsTranexamic acid can be used safely to reduce blood loss during cesarean section. Reduced blood loss after tranexamic acid was associated with improvement of post-operative hemoglobin, hematocrit and with reduction of post-partum need for iron replacement.