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Category: Volume 11 Issue 08 August 2023
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Title: Effect of Tranexamic Acid on Primary Postpartum Haemorrhage in at Risk Women at Abuth, Zaria: A Randomized Controlled Study

Authors: Gabriel Dogbanya, Marliyya S Zayyan, Nana H Madugu, Hajara S Umar

 DOI: https://dx.doi.org/10.18535/jmscr/v11i8.01

Abstract

Background: Postpartum haemorrhage is an obstetric nightmare. Although it may occur in women with no identified risk, women with certain risk profiles are at increased risk PPH. Tranexamic acid has been shown to be effective in low risk women.

Aim: To compare the effectiveness of Tranexamic acid to placebo in preventing PPH in at-risk women following vaginal delivery.

Research Methods: The study was a randomized controlled trial at ABUTH, Zaria, in which 334 women identified as being at risk for PPH, were sequentially randomized into Tranexamic and placebo groups of 167 each. The Tranexamic acid group received intravenous 1g Tranexamic acid made up to 20ml with 0.9% Normal saline, while the placebo group received 20ml 0.9% Normal saline at delivery. Both groups received I.M 10IU oxytocin as part of AMTSL protocol. Blood loss was collected objectively in a blood collection drape at delivery.

Results: The primary outcome, blood loss >500ml, was significantly lower in the study arm 12.9% versus 27.9% p-value =0.001, while the mean blood loss was also significantly lower in the Tranexamic acid arm, 260.61±183.74 versus 365.84±191.79; p-value <0.001. On the secondary outcomes, there was significant difference in mean haemoglobin fall with significant reduction on the need of additional uterotonic agent in the Tranexamic arm of the study, p-value 0.001. There was no significant difference on the need for blood transfusion, and side effect profile in both arms of study p-value 0.075 and 0.124 respectively.

Conclusion: Tranexamic acid is efficacious in reducing PPH in at-risk women during vaginal delivery.

Keywords: Postpartum haemorrhage, Tranexamic acid, at-risk, vaginal delivery.

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Corresponding Author

Gabriel Dogbanya

Ahmadu Bello University Teaching Hospital Zaria, Dept of Obstetrics and Gynaecology