Publication Details
Abstract
To determine the impact of prophylactic tranexamic acid (TA) on both calculated and observed blood loss in women undergoing vaginal delivery who are at low risk of postpartum hemorrhage. This double-blind randomized controlled trial involved 140 women with singleton pregnancies, who were randomly assigned to either receive a placebo or one gram of intravenous tranexamic acid (TA) in combination with 10 IU of oxytocin at the time of fetal delivery. Blood loss was estimated based on hematocrit levels measured before delivery and 12–24 hours postpartum. The blood loss was further quantified by measuring the time elapsed from fetal delivery to placental expulsion and from placental expulsion to the conclusion of the second hour after childbirth. The intervention group experienced significantly lower measured blood loss from placental delivery to two hours postpartum (68 (39) vs. 107 (53) mL, P < 0.001) and reduced mean (SD) calculated total blood loss (516 (312) vs. 655 (400) mL, P = 0.036) compared to the control group. However, there was no notable difference between the groups in blood loss from fetal delivery to placental expulsion. Additionally, the frequency of estimated blood loss exceeding 1000 mL was lower in the TA group (8% vs. 19%, P = 0.048). In conclusion, prophylactic use of tranexamic acid benefits women at low risk of postpartum hemorrhage by effectively reducing blood loss after vaginal delivery. Its preventive use could enhance maternal health and mitigate issues related to excessive blood loss.