Tranexamic Acid in the Prevention of Postpartum Hemorrhage in Elective Caesarean Section

Tranexamic Acid in the Prevention of Postpartum Hemorrhage in Elective Caesarean Section: a Randomised Controlled Trial

In obstetrics, postpartum haemorrhage (PPH) continues to be a major contributor to maternal morbidity and mortality worldwide. Uterine atony is the most common cause of PPH, and the prophylactic use of uterotonics, specifically oxytocin, is the standard of care for PPH prophylaxis. It is believed that tranexamic acid (TXA) can enhance the hemostatic process further by inhibiting the fibrinolytic system.

TXA is an antifibrinolytic that has been studied in many different patient population for its use in reducing blood loss ranging from gynaecological and non gynaecological surgeries, to trauma patients. It has been found to reduce mortality in treatment of patients with PPH, and recent evidence have found promising results in its use for prophylaxis of PPH.

Inclusion Criteria:

• All English speaking patients
• Above 21 year old
• Undergoing elective caesarean section.

Exclusion Criteria:

• Known/suspected placenta accreta antenatally
• Contraindications to syntocinon and tranexamic acid such as hypersensitivity to these medications
• Known thrombophilia or coagulopathy
• History of thromboembolic events
• Severe cardiac/renal/liver disease
• Poorly controlled hypertension /severe preeclampsia (BP > 160/100)/eclampsia