Iqbal Muhammad Jawad, Mazhar Atifa, Shabir Alina
Dr. Muhammad Jawad Iqbal, MBBS, MO, Department of Gynecology. Nishtar Medical University & Hospital, Multan, Pakistan.
Dr. Atifa Mazhar, MBBS, MO, Department of Gynecology. Nishtar Medical University & Hospital, Multan, Pakistan.
Pak J Med Sci. 2022 May-Jun;38(5):1183-1187. doi: 10.12669/pjms.38.5.5383.
To evaluate the effectiveness of Tranexamic Acid in preventing postpartum hemorrhage against placebo in high-risk women undergoing cesarean section.
A double-blinded placebo-controlled comparative trial was conducted at the Obstetrics and Gynecology Department of Nishtar Hospital for one year, from 15 June 2020 to 15 June 2021. A total of 60 women who were at high risk of postpartum hemorrhage and had to undergo elective cesarean sections were included in the study. Among them, initial 30 patients were administered Tranexamic Acid before skin incision whereas later 30 were treated as the placebo group. These women were then observed for blood loss during surgery and within 24 hrs. after surgery and any postoperative complications such as thromboembolic events, the need for additional uterotonic agents, and blood transfusions.
Out of 60 women, 30 were placed in each group. The groups had no significant difference in terms of baseline data and post-partum hemorrhage-associated risk factors (p>0.05). However, the occurrence rate of primary post-partum hemorrhage (blood loss greater than 1000 ml) was significantly less in a tranexamic acid group than the placebo group (16.6% vs 60%, respectively, p<0.01). Similarly, the requirement of additional uterotonic agents (13.3% vs 43.3%, respectively) and the need for blood transfusion (6.0% vs 23.3%, respectively) was lower in a tranexamic group than in the placebo group.
The study highlighted the significance of tranexamic acid in controlling post-partum hemorrhages, the requirement of additional uterotonic agents, improving post-partum hemoglobin, and the need for blood transfusion.
评估氨甲环酸在剖宫产高危女性中预防产后出血相对于安慰剂的有效性。
于2020年6月15日至2021年6月15日在尼什塔尔医院妇产科进行了一项为期一年的双盲安慰剂对照比较试验。共有60名有产后出血高危风险且必须接受择期剖宫产的女性纳入研究。其中，最初30例患者在皮肤切开前给予氨甲环酸，而后30例作为安慰剂组。随后观察这些女性手术期间及术后24小时内的失血量以及任何术后并发症，如血栓栓塞事件、额外使用宫缩剂的需求和输血情况。
60名女性中，每组各30名。两组在基线数据和产后出血相关危险因素方面无显著差异（p>0.05）。然而，氨甲环酸组原发性产后出血（失血量大于1000 ml）的发生率显著低于安慰剂组（分别为16.6%和60%，p<0.01）。同样，氨甲环酸组额外使用宫缩剂的需求（分别为13.3%和43.3%）和输血需求（分别为6.0%和23.3%）低于安慰剂组。
该研究强调了氨甲环酸在控制产后出血、额外使用宫缩剂的需求、改善产后血红蛋白水平以及输血需求方面的重要性。
