Affiliation:
1. Senior Resident at Department of Obs. and Gynae PMCH, Patna.
2. Associate Professor at Department of Obs. and Gynae PMCH, Patna.
Abstract
Introduction: The reduction of maternal mortality is one of the indicators under Goal 3- Ensure healthy lives and promote well-being for all at all
ages of Sustainable Development Goals. It seeks to reduce global MMR to less than 70 per 100 000 live births by 2030. A leading cause of maternal
mortality is Post-partum Haemorrhage (PPH). Hence, it is imperative that any improvement in maternal mortality rate must address the issue of
Post-partum Haemorrhage.
Post-partum Haemorrhage (PPH) is dened as the amount of blood loss in excess of 500 ml following the birth of the baby (World Health
Organization). The clinical denition, which is more practical, states, any amount of bleeding from or into the genital tract following the birth of the
baby up to the end of the puerperium, which adversely affects the general condition of the patient evidenced by the rise in pulse rate and falling
blood pressure, is called Post-partum Haemorrhage.
Aim: The present study is aimed to determine the clinical efcacy of tranexamic acid in reducing blood loss during elective caesarean section in
Patna Medical College and Hospital, Patna.
Type of study: Prospective study
Study period: 1 year (January 2020 to December 2020)
Materials and Methods: This is a prospective study conducted in Obstetrics and Gynaecology department at Patna Medical College and Hospital,
Patna. 100 female patients scheduled for elective caesarean section are enrolled for the present prospective study, which was carried out from
January 2020 to December 2020. The patients were randomly divided into 2 groups. 50 patients received 1g intravenous tranexamic acid 10
rd
minutes before skin incision in addition to active management of 3 stage of labour and the other 50 patients were kept under the active
rd
management of 3 stage of labour only.
Result: In the present study, the amount of blood loss was found to be signicantly low (mean 537 ml) in the tranexamic acid group as compared to
the control group (608 ml), the difference was statistically signicant (p-value 0.001). The mean fall in haemoglobin level was also less (0.61
mg/dl) in the group which received the tranexamic acid as compared to the control group (1.07 mg/dl), the difference was statistically signicant (p-
value 0.001). Postpartum haemorrhage (blood loss more than 1000 ml) was observed in 1 patient in the control group and no case of PPH was
observed in the study group.
Conclusion: To reduce blood loss following caesarean section, TXAmay be safely recommended in addition to Oxytocin.
Reference10 articles.
1. WHO recommendations for the prevention and treatment of postpartum haemorrhage. World Health Organization; Available at: http://www.who.int/reproductivehealth/publications/maternal_perinatal_health/9789241548502/en/. Accessed on 12th April 2020.
2. Shahid A, Khan A. Tranexamic acid in decreasing blood loss during and after caesarean section. J Coll Physicians Surg Pak. 2013;23:459-62.
3. Nath J. A study on use of tranexamic acid in reducing blood loss during lower segment caesarean section. Int J Sci Res. 2015;4:1236-8.
4. Sunda U, Bhadana P. Prophylactic use of tranexamic acid to reduces blood loss and transfusion requirements in caesarean section. Int J Reprod Contracept Obstet Gynecol 2020;9:2987-91
5. American College of Obstetricians and Gynecologists. Clinical Management Guidelines for Obstetrician-Gynecologists Number 76, October 2006: postpartum hemorrhage. Obstet Gynecol. 2006;108:1039-47.