Effect of preoperative tranexamic acid administration on intraoperative blood loss during caesarean section: A randomized controlled trial at Irrua, Nigeria

Abstract

Tranexamic acid combats primary postpartum haemorrhage, but its preoperative use could significantly reduce morbidities and mortality  especially during Caesarean sections. This study at Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria, was designed to  determine the effect of preoperative tranexamic acid on intraoperative blood loss and the need for additional oxytocic during Caesarean  sections. The double-blinded randomized placebo-controlled trial method was used and the study involved 208 randomly assigned  women that met the inclusion criteria, and aged 18years and above for primary Caesarean section. Data analysis was done with statistical  significance considered at p-value of <0.05. The results showed that the mean blood loss (502.84±234.565 ml) in the tranexamic  acid group was significantly less than the mean blood loss (699.46±177.407 ml) in the placebo group (t=6.75; p<0.01), but the  tranexamic acid group had an 81% reduced risk of requiring additional oxytocic compared to the placebo group, without any significant  difference in 1st minute (p= 0.394) and 5th minute (p=0.737) APGAR scores. These findings suggest a significant reduction in  intraoperative blood loss and additional oxytocic requirement, without additional maternal or perinatal risks following preoperative use  of tranexamic acid.