To Study the Effect of Intravenous Tranexamic Acid on Blood Loss During and After Caesarean Section

Abstract

Introduction: Incidence of postpartum haemorrhage is 6.4% in caesarean section. WHO guidelines for prevention of PPH include oxytocin as first line drug. Intravenous tranexamic acid has been used to reduce hemorrhage during surgical procedures. In this study use of tranexamic acid on blood loss during and after Lower Segment Caesarean Section (LSCS) was evaluated. Aims and Objectives: 1. To study the efficacy of tranexamic acid in reducing blood loss during and after lower segment caesarean section, and 2. To study any side effect on neonate. Materials and Methods: A randomized prospective observational study of 100 patients were conducted. Patients were divided into: Group (A group) had received 1 gm tranexamic acid intravenous 20 minutes before skin incision + 20 units oxytocin drip in 500ml Ringer Lactate after delivery of baby. Group (B group) received only 20 units oxytocin drip in 500ml Ringer Lactate after delivery of baby. Patient's blood loss was measured (intra operative, post placental and post-operative period) by weighing dry and soaked mops and separate suction bottle for blood. Results: Statistically significant difference (P < 0.001) in the quantity of blood loss was observed. In group A total blood loss during LSCS was 476.49 ml while in group B it was 576.06 ml. Intra operative blood loss in group A was 455.63 ml while in group B it was 536.53 ml. Post placental blood loss in group A was 411.59 ml while in group B was 485.08 ml. Not a single neonate had poor APGAR score and no NICU admission was required. Conclusion: Use of tranexamic acid with oxytocin significantly decreased blood loss during and after caesarean section without any side effect on neonate.