Role of tranexamic acid in the treatment of postpartum hemorrhage following cesarean section a randomized controlled trial

Abstract

Primary post-partum hemorrhage (PPH) is defined as blood loss greater than or equal to 500 ml within 24 hours after birth, while severe PPH is blood loss greater than or equal to 1000 ml within 24 hours. According to national statistics in Egypt, Hemorrhage before and after delivery was the leading direct cause of maternal death (43%), with most hemorrhage deaths due to postpartum hemorrhage. There were 32 maternal deaths with hemorrhage per 100,000 live births. Figures for other causes were much less than hemorrhage (e.g. hypertensive diseases were 18 per 100,000, for sepsis 7 per 100,000, for ruptured uterus 7 per 100,000, for cesarean section 6 per 100,000, for obstructed labor 4 per 100,000, for cardiac disease 11 per 100,000 and for anemia 9 per 100,000). The increased frequency of PPH in the developing world- which is reflected by the rates given above - is mainly due to expectant management because of lack of availability of medications used in the active management of the third stage. Thus our study was held on the steps of previous studies to assess the efficiency of the use of tranexamic acid in treatment of patient with clinically diagnosed postpartum hemorrhage after cesarean sections. In the current study a Randomized controlled trial was carried out on 80 women clinically diagnosed with PPH after cesarean section done in the labor ward in Ain Shams University maternity hospital.