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

Objective: To evaluate the efficacy of tranexamic acid in reduction of blood loss during and after cesarean section.Methods: Women 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.Results: Twenty 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).Conclusions: Tranexamic 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