Binyamin Yair, Orbach-Zinger Sharon, Gruzman Igor, Frenkel Amit, Lerman Sofia, Zlotnik Alexander, Frank Dmitry, Ioscovich Alexander, Erez Offer, Heesen Michael
Department of Anesthesiology, Soroka University Medical Center, Beer-Sheva, Israel.
Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
J Matern Fetal Neonatal Med. 2022 Dec;35(25):9157-9162. doi: 10.1080/14767058.2021.2019215. Epub 2022 Jan 23.
Treatment with tranexamic acid (TxA) significantly reduces maternal death due to postpartum hemorrhage. There is increasing interest in whether it can also be used as prophylaxis for postpartum hemorrhage, especially during cesarean sections (CS). This impact study is aimed to determine the effect of routine prophylactic tranexamic acid during CS on maternal hemorrhage and the rate of the associated side effects.
This retrospective population-based cohort single-center impact study include 2000 women who delivered by CS divided into two groups with ( = 1000) and without ( = 1000) prophylactic administration of 1gram TxA prior to surgery. Primary outcomes were to determine the: (1) rate of women experiencing >10% or ≥2 g/dL hemoglobin drop from the preoperative concentration within 24 h after CS. (2) incidence of women having a hemoglobin drop of ≥2 g/dL.
Women who did not receive TxA prophylactic had a higher rate of >10% hemoglobin decrease and a higher rate of ≥2 g/dL hemoglobin decrease Than those who received TxA prophylaxis ( < .0001, for both). Mean hospital stay ( = .002) and umbilical cord pH ( < .05) were higher among those who received TxA prophylaxis than in those who were not treated.
The finding of our study suggest that prophylactic administration of TxA prior to CS improves maternal and neonatal outcomes.
氨甲环酸(TxA)治疗可显著降低产后出血导致的孕产妇死亡。对于其是否也可用于预防产后出血,尤其是剖宫产(CS)期间的产后出血,人们的兴趣日益浓厚。本影响研究旨在确定剖宫产期间常规预防性使用氨甲环酸对孕产妇出血及相关副作用发生率的影响。
这项基于人群的回顾性队列单中心影响研究纳入了2000例剖宫产分娩的女性,分为两组,一组(n = 1000)在手术前预防性给予1克氨甲环酸,另一组(n = 1000)未给予。主要结局是确定:(1)剖宫产术后24小时内血红蛋白浓度较术前下降>10%或≥2 g/dL的女性比例。(2)血红蛋白下降≥2 g/dL的女性发生率。
未接受氨甲环酸预防性用药的女性血红蛋白下降>10%的比例和血红蛋白下降≥2 g/dL的比例均高于接受氨甲环酸预防性用药的女性(两者均P <.0001)。接受氨甲环酸预防性用药的女性平均住院时间(P = 0.002)和脐动脉血pH值(P < 0.05)均高于未接受治疗的女性。
我们的研究结果表明,剖宫产术前预防性使用氨甲环酸可改善孕产妇和新生儿结局。