Publication:

Role of tranexamic acid in prevention of blood loss during cesarean section

Background Postpartum hemorrhage remains one of the leading causes of maternal morbidity and mortality worldwide. Cesarean section is associated with significantly greater blood loss compared to vaginal delivery. Tranexamic acid (TXA), a synthetic antifibrinolytic agent, has shown promise in reducing perioperative bleeding by inhibiting plasminogen activation and preventing fibrin degradation. The objectives were to evaluate the efficacy of tranexamic acid in reducing intraoperative and postoperative blood loss during cesarean section, to assess postoperative hemoglobin drop, and to determine the need for blood transfusion.

Methods A prospective randomized controlled study was conducted over three months in the Department of Obstetrics and Gynecology. Sixty women undergoing cesarean section were randomized into two groups of 30 each. Group A received 1 g intravenous TXA 10 minutes prior to skin incision, while group B received normal saline. Blood loss was estimated by suction bottle volume, sponge weight, and postoperative drain output. Hemoglobin was measured preoperatively and 24 hours postoperatively.

Results The mean intraoperative blood loss was significantly lower in the TXA group (420 ml) compared to the control group (610 ml) (p<0.001). Postoperative hemoglobin drops and need for blood transfusion were also significantly reduced in group A. The incidence of postpartum hemorrhage was lower in the TXA group.

Conclusion Prophylactic administration of tranexamic acid significantly reduces blood loss during cesarean section and is safe and well tolerated. It may be considered a valuable intervention in obstetric practice to prevent postpartum hemorrhage.