Injection Tranexamic Acid in Preventing Postpartum Hemorrhage Following Vaginal Delivery: A One-year Hospital-based Randomized Placebo-controlled Trial

Introduction: Tranexamic acid (TXA) injections, known for their antifibrinolytic properties, are gaining wider acceptance as a treatment for postpartum hemorrhage (PPH) on a global scale. Aims and objectives:The purpose of this study was to evaluate the effectiveness of TXA and its potential side effects in preventing PPH following vaginal birth.Materials and methods: This randomized controlled trial, conducted in a multispecialty hospital in Belagavi, India, involved 210 term patients over 1 year from January to December 2019.Subjects were randomly assigned into two cohorts using computer-based randomization.Each cohort received 10 prophylactic units of oxytocin.One group received 1 gm of intravenous TXA, while the other received 10 mL of normal saline intravenously within 2 minutes after delivery.Blood loss was measured using calibrated drapes, and mean changes in hemoglobin (Hb) and packed cell volume (PCV) were assessed from pre-delivery to postnatal day 2. Data assessment was carried out using the statistical program R i386 3.6.3.Results: Patients in the research had an average age of 23.43 years with a standard deviation (SD) of 3.26 years.The occurrence of PPH was observed in 5 individuals (4.85%) in the TXA group and 12 individuals (11.21%) in the placebo group (p = 0.0912).Furthermore, the mean blood loss was significantly lesser in the TXA group, measuring 250.10 mL with an SD of 133.54 mL, compared to 334.2 mL with an SD of 141.78 mL in the placebo group (p < 0.0001).Conclusion: Tranexamic acid can serve as a supplementary treatment alongside uterotonics during the third stage of labor, given its demonstrated clinical effectiveness and safety in preventing PPH.