School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.
School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.
Arch Gynecol Obstet. 2023 Sep;308(3):709-725. doi: 10.1007/s00404-022-06845-1. Epub 2022 Nov 27.
Africa is a developing continent with a high maternal mortality rate. It is beneficial to implement interventions that alleviate the problem. As a result, this systematic review and meta-analysis was carried out to summarize evidence that will assist concerned bodies in proposing strategies to reduce maternal mortality due to post-partum hemorrhage.
This systematic review and meta-analysis includes randomized control trials (RCT) studies searched from various databases (PubMed, Web of Sciences, SCOPUS, African Journal Online, Clinical trials, and African indexes Medics). Data synthesis and statistical analysis were conducted using a combination of review manager 5.3 and STATA Version 14 software. The effect measure utilized was the standardized mean difference for estimated mean blood loss and mean hemoglobin level.
This systematic review and meta-analysis includes a total of 3308 women. The pooled standardized mean difference showed that tranexamic acid statistical significantly reduced the estimated amount of blood loss after vaginal delivery (standardized mean difference with 95% CI - 0.93 [- 1.45, - 0.41]) and during and after cesarean delivery (standardized mean difference with 95% CI - 1.93 [- 2.40, - 1.47]).
Tranexamic acid has been found to be a good choice for reducing blood loss during and after delivery in Africa regardless of the mode of delivery. Tranexamic acid had no effect on hemoglobin levels before and after delivery. To reduce maternal mortality due to post-partum hemorrhage, it is critical to implement and strengthen interventions aimed at increasing tranexamic acid uptake in Africa.
非洲是一个发展中大陆，孕产妇死亡率较高。实施缓解问题的干预措施是有益的。因此，进行了这项系统评价和荟萃分析，以总结有助于有关机构提出策略以减少产后出血导致的孕产妇死亡的证据。
这项系统评价和荟萃分析包括从各种数据库（PubMed、Web of Sciences、SCOPUS、African Journal Online、Clinical trials 和 African indexes Medics）搜索的随机对照试验（RCT）研究。使用 Review Manager 5.3 和 STATA 版本 14 软件进行数据综合和统计分析。使用估计平均失血量和平均血红蛋白水平的标准化均数差作为效应量。
这项系统评价和荟萃分析共纳入 3308 名妇女。荟萃分析显示，氨甲环酸统计学上显著减少了阴道分娩后的估计失血量（标准化均数差 95%置信区间 -0.93[-1.45，-0.41]）和剖宫产术中及术后的失血量（标准化均数差 95%置信区间 -1.93[-2.40，-1.47]）。
氨甲环酸在非洲被发现是减少分娩期间和之后失血的良好选择，无论分娩方式如何。氨甲环酸对分娩前后的血红蛋白水平没有影响。为了减少因产后出血导致的孕产妇死亡，在非洲实施和加强旨在增加氨甲环酸使用率的干预措施至关重要。
