Effect of intravenous tranexamic acid administration on blood loss during and after cesarean delivery

Objective: To assess the effect of intravenous tranexamic acid on blood loss during and after cesarean delivery. Methods: One hundred pregnant women were randomized to receive either 10 mg/kg of tranexamic acid or placebo intravenously 20 minutes before incision in a double-blind controlled study. Postplacental delivery blood loss, postoperative hemorrhage 2 hours after surgery, and oxytocin administration were recorded. Results: The patients' mean age, weight, and duration of surgery were similar between the 2 groups. Mean blood loss was significantly less in the tranexamic acid group compared with the control group for both intraoperative bleeding (262.5 +/- 39.6 vs 404.7 +/- 94.4 mL) and postoperative bleeding (67.1 +/- 6.5 vs 141.0 +/- 33.9 mL; P<0.001), respectively. Oxytocin administration was significantly less in the tranexamic acid group compared with the control group (39 +/- 5.8 vs 43 +/- 5.4 units; P=0.001). Conclusion: Intravenous tranexamic acid decreased intra- and postoperative blood loss and oxytocin administered in patients delivered by cesarean. (C) 2011 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.