婦人科腫瘍学の現在の動向

抽象的な

Efficacy of tranexamic acid in reducing blood loss in low transverse cesarean section- a double-blind, randomized controlled trial

Ana Katrina, University of Santo Tomas Hospital, Philippines

Postpartum hemorrhage has an estimated mortality rate of 140,000 per year or one maternal death every four minutes1 WHO in 2017 estimates that in India, 529,000 maternal death occur every year, wherein 136,000 or 25.7% of death takes place and two third of these deaths occur after delivery. 1

Objectives: To study the effectiveness of prophylactic administration of tranexamic acid in reducing blood loss in low transverse cesarean sections and to determine side effects.

Methodology: Participants were randomized into two groups by simple randomization and assigned to their treatments accordingly after being satisfying the eligibility criteria. The study group was given 1 g TA administered intravenously 10 minutes before the start of the cesarean section; in addition to 10 IU oxytocin per IV after delivery of the baby. The control group was given a corresponding volume of sterile saline as placebo (10 mL) and also received 10 IU oxytocin intravenously (IV) after delivery of the baby.

Results: Tanexamic acid group had significantly lower amounts of blood loss compared to those in the placebo for all time endpoints both from the total blood loss from placental delivery and 2 hours postpartum. Two side effects were noted in study group, nausea (35%) and vomiting (7%).

Conclusion: Tranexamic acid reduces the risk of post-partum bleeding by 26.32% (ARR 95% CI 17.46% to 35.17% risk reduction in PPH), and the number needed to treat to prevent one adverse event is 4 patients. It did not show significant maternal adverse effect nor fetal side effects.