Efficacy of Tranexamic Acid in Reducing Blood Loss Following Vaginal Delivery: A Double-Blind Randomized Controlled Trial

Background: Postpartum haemorrhage (PPH) is a major cause of maternal mortality worldwide. This study aimed to evaluate the efficacy of tranexamic acid (TXA) in reducing blood loss following vaginal delivery in an Indian setting. Method: A double-blind, randomized controlled trial was conducted at SMS Medical College, Jaipur, from April 2023 to October 2023. A total of 130 women undergoing vaginal delivery were randomly assigned to receive either 1g of TXA (Group A) or placebo (Group B) intravenously within 2 minutes of delivery. Blood loss was measured using graduated drapes and weighed swabs. Secondary outcomes included estimation of change in hemoglobin and hematocrit levels, need for additional uterotonics, and blood transfusions. Statistical analysis was performed using IBM SPSS version 23.0.0. Results: The TXA group demonstrated a significant reduction in mean blood loss (347.23 ± 96.92 ml) compared to the placebo group (399.07 ± 98.08 ml, p = 0.003). Hemoglobin and hematocrit levels were significantly higher in the TXA group post-delivery (hemoglobin: 9.97 ± 0.80 gm%, p < 0.001; hematocrit: 37.47 ± 1.55%, p = 0.001). Additionally, fewer patients in the TXA group required additional uterotonics (7.6% vs. 21.53%, p = 0.025) and blood transfusions (3.07% vs. 12.30%, p = 0.048). Hospital stay was shorter for the TXA group (p = 0.048). Conclusion: Prophylactic administration of TXA significantly reduces blood loss following vaginal delivery, decreases the need for additional uterotonics, and shortens hospital stay. These findings suggest that TXA can be a valuable tool in the prevention of PPH, particularly in resource-limited settings.