BACKGROUND: Cesarean delivery is a widely practiced obstetric surgery associated with blood loss. Different measures were described to decrease perioperative blood loss. Tranexamic acid proved effective in decreasing blood loss among women undergoing cesarean delivery. This study aimed to evaluate the difference between two dose regimens of tranexamic acid on blood loss among women undergoing cesarean delivery. METHODS: This randomized clinical trial was conducted at the operating theater of Suez Canal University Hospital from August 20, 2022, to February 23, 2023. We recruited women undergoing cesarean delivery after matching particular inclusion and exclusion criteria. These women received 10 mg/kg (group 1) or 20 mg/kg (group 2) of tranexamic acid before the skin incision. The primary objective was the amount of blood loss between both groups. RESULTS: The general characteristics of the patients in the two groups were comparable but for body mass index (BMI). There was no discernible difference in the perioperative blood loss between both groups ( p value .123). Five patients in group 1 (received 10 mg/kg tranexamic acid) and two patients in group 2 (received 20 mg/kg tranexamic acid) developed postpartum hemorrhage (blood loss >1,000 ml). Nausea was significantly higher in group 1, 22 (32.8%), compared with 13 (19.4%) in group 2 ( p value .077). None of the participants developed thromboembolic complications. Linear regression analysis revealed no significant factors associated with high bleeding risk except BMI. CONCLUSION: There was no difference between the two doses in perioperative blood loss among women undergoing cesarean delivery. CLINICAL TRIAL REGISTRATION NUMBER: PACTR202208859856197.
Elewa et al. (2025) studied this question.