Effect of Prophylactic Intravenous Tranexamic Acid on Blood Loss After Vaginal Delivery: A Randomized Control Study

ABSTRACT Background and Aim To determine the effect of prophylactic intravenous tranexamic acid on blood loss after vaginal delivery in women at low risk of postpartum hemorrhage. Methods Prospective randomized controlled study (RCT registration: researchregistry10144). Over the study duration of 12...

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Main Authors: Sajana Shrestha, Shelisha Uprety, Ravi Shah, Brinda Kharel
Format: Article
Language:English
Published: Wiley 2025-02-01
Series:Health Science Reports
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Online Access:https://doi.org/10.1002/hsr2.70415
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author Sajana Shrestha
Shelisha Uprety
Ravi Shah
Brinda Kharel
author_facet Sajana Shrestha
Shelisha Uprety
Ravi Shah
Brinda Kharel
author_sort Sajana Shrestha
collection DOAJ
description ABSTRACT Background and Aim To determine the effect of prophylactic intravenous tranexamic acid on blood loss after vaginal delivery in women at low risk of postpartum hemorrhage. Methods Prospective randomized controlled study (RCT registration: researchregistry10144). Over the study duration of 12 months, a total of 226 parous women with singleton vaginal delivery at term pregnancy with cephalic presentation participated in the study. Participants with pre‐existing medical complications and obstetric complications were excluded from the study. Additionally, patients with a previous history of thromboembolism and allergy to tranexamic acid were also excluded from the study. The study participants were divided into two groups based on the intervention considered. This was done with a computer‐based random table generator. Group A received an intervention of 10 mL (1 g) of intravenous tranexamic acid while the other group received 10 mL of normal saline as a placebo immediately after delivery of the fetus. Blood loss was calculated by measuring the weights of blood‐soaked gauze, gowns, sheets, and tampons before and after delivery. Hemoglobin and hematocrit were done before and 12 h after delivery. Results Total number of participants were 226. The mean calculated blood loss and the mean measured blood loss was significantly less in Group A in comparison to Group B (379.17 ± 46.89 mL in Group A and 426.66 ± 58.45 mL in Group B, p < 0.001), (247.88 ± 67.03 mL in Group A and 368.95 ± 58.54 mL in group B, p < 0.001). Similarly, the mean decrease of hemoglobin after delivery was lower for Group A (1.45 ± 0.14) than for Group B (1.74 ± 0.24). Conclusion The use of prophylactic intravenous tranexamic acid is associated with reduced blood loss after vaginal delivery. Furthermore, research needs to be done.
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spelling doaj-art-88641d3114ab4decb50ba13ae112ca8d2025-08-20T02:11:08ZengWileyHealth Science Reports2398-88352025-02-0182n/an/a10.1002/hsr2.70415Effect of Prophylactic Intravenous Tranexamic Acid on Blood Loss After Vaginal Delivery: A Randomized Control StudySajana Shrestha0Shelisha Uprety1Ravi Shah2Brinda Kharel3Tree Top Hospital Hulhumale MaldivesHelping Hand Community Hospital Kathmandu NepalNepalese Army Institute of Health Sciences Kathmandu NepalNational Medical College Birgunj NepalABSTRACT Background and Aim To determine the effect of prophylactic intravenous tranexamic acid on blood loss after vaginal delivery in women at low risk of postpartum hemorrhage. Methods Prospective randomized controlled study (RCT registration: researchregistry10144). Over the study duration of 12 months, a total of 226 parous women with singleton vaginal delivery at term pregnancy with cephalic presentation participated in the study. Participants with pre‐existing medical complications and obstetric complications were excluded from the study. Additionally, patients with a previous history of thromboembolism and allergy to tranexamic acid were also excluded from the study. The study participants were divided into two groups based on the intervention considered. This was done with a computer‐based random table generator. Group A received an intervention of 10 mL (1 g) of intravenous tranexamic acid while the other group received 10 mL of normal saline as a placebo immediately after delivery of the fetus. Blood loss was calculated by measuring the weights of blood‐soaked gauze, gowns, sheets, and tampons before and after delivery. Hemoglobin and hematocrit were done before and 12 h after delivery. Results Total number of participants were 226. The mean calculated blood loss and the mean measured blood loss was significantly less in Group A in comparison to Group B (379.17 ± 46.89 mL in Group A and 426.66 ± 58.45 mL in Group B, p < 0.001), (247.88 ± 67.03 mL in Group A and 368.95 ± 58.54 mL in group B, p < 0.001). Similarly, the mean decrease of hemoglobin after delivery was lower for Group A (1.45 ± 0.14) than for Group B (1.74 ± 0.24). Conclusion The use of prophylactic intravenous tranexamic acid is associated with reduced blood loss after vaginal delivery. Furthermore, research needs to be done.https://doi.org/10.1002/hsr2.70415antifibrinolytic agentshemoglobinpostpartum hemorrhagepregnancytranexamic acid
spellingShingle Sajana Shrestha
Shelisha Uprety
Ravi Shah
Brinda Kharel
Effect of Prophylactic Intravenous Tranexamic Acid on Blood Loss After Vaginal Delivery: A Randomized Control Study
Health Science Reports
antifibrinolytic agents
hemoglobin
postpartum hemorrhage
pregnancy
tranexamic acid
title Effect of Prophylactic Intravenous Tranexamic Acid on Blood Loss After Vaginal Delivery: A Randomized Control Study
title_full Effect of Prophylactic Intravenous Tranexamic Acid on Blood Loss After Vaginal Delivery: A Randomized Control Study
title_fullStr Effect of Prophylactic Intravenous Tranexamic Acid on Blood Loss After Vaginal Delivery: A Randomized Control Study
title_full_unstemmed Effect of Prophylactic Intravenous Tranexamic Acid on Blood Loss After Vaginal Delivery: A Randomized Control Study
title_short Effect of Prophylactic Intravenous Tranexamic Acid on Blood Loss After Vaginal Delivery: A Randomized Control Study
title_sort effect of prophylactic intravenous tranexamic acid on blood loss after vaginal delivery a randomized control study
topic antifibrinolytic agents
hemoglobin
postpartum hemorrhage
pregnancy
tranexamic acid
url https://doi.org/10.1002/hsr2.70415
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