Fahrenholtz Charles G, Bonanno Laura S, Martin Jennifer B
School of Nursing, Louisiana State University Health Science Center New Orleans, New Orleans, USA.
The Louisiana Center for Promotion of Optimal Health Outcomes: a Joanna Briggs Institute Center of Excellence.
JBI Database System Rev Implement Rep. 2019 Aug;17(8):1565-1572. doi: 10.11124/JBISRIR-2017-003978.
The objective of this review is to evaluate the effectiveness of intravenous administration of tranexamic acid (TXA) within three hours of birth in mothers with a diagnosis of postpartum hemorrhage (PPH).
Postpartum hemorrhage, that is, blood loss exceeding 500 mL for vaginal births or 1000 mL for cesarean sections within 24 hours of delivery, is the leading cause of maternal deaths worldwide. The World Health Organization recommends intravenous TXA as an adjuvant therapy for the treatment of PPH, in addition to standard recommended treatments, within three hours of birth. This review will determine whether TXA administration to patients experiencing PPH leads to a reduction in blood loss, the requirement for transfusion of packed red blood cells and the need for emergency hysterectomies, in both developed and developing nations.
This review will consider studies that include women under 40 with a diagnosis of postpartum hemorrhage. Studies that evaluate intravenous administration of TXA within three hours of birth as adjuvant treatment of postpartum hemorrhage will be considered. The comparator will be groups that have not received TXA as part of the treatment for postpartum hemorrhage, with or without placebo.
MEDLINE, Embase, CINAHL, CENTRAL, Scopus, Web of Science and ProQuest Nursing and Allied Health will be searched for eligible studies. The search for unpublished studies will include: ProQuest Dissertations and Theses (PQDT), ClinicalTrials.gov and New York Academy of Medicine Grey Literature Report. Retrieval of full-text studies, assessment of methodological quality and data extraction will be performed independently by two reviewers. Meta-analysis will be performed, if possible.
本综述的目的是评估在诊断为产后出血（PPH）的母亲中，在出生后三小时内静脉注射氨甲环酸（TXA）的有效性。
产后出血，即在分娩后24小时内，经阴道分娩失血超过500毫升或剖宫产失血超过1000毫升，是全球孕产妇死亡的主要原因。世界卫生组织建议，除标准推荐治疗外，在出生后三小时内静脉注射TXA作为治疗PPH的辅助疗法。本综述将确定在发达国家和发展中国家，对发生PPH的患者使用TXA是否能减少失血量、减少输注浓缩红细胞的需求以及减少紧急子宫切除术的需求。
本综述将考虑纳入诊断为产后出血的40岁以下女性的研究。将考虑评估在出生后三小时内静脉注射TXA作为产后出血辅助治疗的研究。对照组将是未接受TXA作为产后出血治疗一部分的组，无论是否使用安慰剂。
将检索MEDLINE、Embase、CINAHL、CENTRAL、Scopus、Web of Science以及ProQuest护理与联合健康数据库，以查找符合条件的研究。对未发表研究的检索将包括：ProQuest学位论文数据库（PQDT）、ClinicalTrials.gov以及纽约医学院灰色文献报告。两名评审员将独立进行全文研究的检索、方法学质量评估以及数据提取。如有可能，将进行荟萃分析。
