Evaluation of the Role of Tranexamic Acid in Prevention of Postpartum Bleeding: A Case Control Study Al-Nasrawi Hayfaa Specilist, AL-Shamiyaa Hospital, Ministry of Health, Iraq Online published on 27 November, 2019. Abstract Background The usual trend in obstetrics field is to use uterotonics in order to control postpartum hemorrhage such as oxytocin, misoprostol and prostaglandins, however, there is a recent trend to use tranexamic acid to prevent and control excessive vaginal bleeding after delivery. The aim of current study was to evaluate the use of tranexamic acid in preventing excessive vaginal bleeding following delivery in a sample of pregnant Iraqi ladies. Method The present randomized controlled clinical trial included two groups; the first included 39 term pregnant ladies who were given tranexamic acid in addition to the standard uterotonic medication used to prevent postpartum hemorrhage in risky women. The second group included 39 term pregnant women who received the standard uterotonic medication only. The first step was to choose women having risk of developing postpartum hemorrhage. Those women were selected from the pool of pregnant ladies visiting the delivery wards at AL-Diwaniyah maternity and child hospital and AL-Shamiyah general hospital during the period from January 2017 to January 2019. These hospitals belong to AL-Diwaniyah province in the Mid-Euphrates region of Iraq. Results The incidence of postpartum bleeding was less significant in women treated with tranexamic acid and uterotonics than women treated with uterotonics alone (46.2% and 76.9%, respectively, P = 0.005). In addition, mean volume of blood loss was significantly less in the first than in the second group of women (288.46 ml versus 538.46 ml, respectively, P= 0.001). Moreover, the need for blood transfusion was significantly less in the first than the in the second group of women (38.5% versus 61.5%, respectively, P = 0.042). Conclusion It seems much recommended to use tranexamic acid in women at risk of having postpartum hemorrhage, because of its high efficacy in reducing the rate and volume of postpartum bleeding, if it ever happens. Top Keywords Tranexamic acid, postpartum hemorrhage, uterotonic, prostaglandin, blood transfusion. Top |