Department of Obstetrics and Gynecology, October 6th University, Giza, Egypt.
Department of Obstetrics and Gynecology, Al-Azhar University, Cairo, Egypt.
J Perinat Med. 2020 Oct 19;49(3):353-356. doi: 10.1515/jpm-2020-0271. Print 2021 Mar 26.
To investigate whether etamsylate may be an alternative to tranexamic acid in reduction of blood loss during elective cesarean section.
Prospective double-blinded multi-center randomized controlled trial involving 180 qualified women equally divided into three groups each containing 60 women received either tranexamic acid, etamsylate or placebo 20 min before elective cesarean section and blood loss was estimated.
Mean blood loss, cases needing blood transfusion and cases needing further interventions were significantly lower in tranexamic acid and etamsylate group than placebo group, while mean postoperative hemoglobin and hematocrite were significantly higher in both tranexamic acid and etamsylate as compared to placebo.
Etamsylate is an effective second-line therapy (after tranexamic acid) in reducing blood loss during elective cesarean section with low risk of side effects, therefore, it can be an effective alternative to tranexamic acid in cases with contraindications or anticipated to be at high-risk of developing side effects from tranexamic acid.
研究氨甲环酸可否替代止血环酸，减少择期剖宫产术中的出血量。
前瞻性、双盲、多中心随机对照试验，纳入 180 名符合条件的妇女，平均分为三组，每组 60 人，分别在择期剖宫产术前 20 分钟给予氨甲环酸、止血环酸和安慰剂，估计出血量。
与安慰剂组相比，氨甲环酸和止血环酸组的平均出血量、需要输血的病例数和需要进一步干预的病例数明显减少，而氨甲环酸和止血环酸组的术后平均血红蛋白和血细胞比容明显高于安慰剂组。
止血环酸是一种有效的二线治疗药物（在氨甲环酸之后），可减少择期剖宫产术中的出血量，且副作用风险低，因此，对于有禁忌证或预计氨甲环酸副作用风险高的患者，它可以替代氨甲环酸。
