Shrestha Sajana, Uprety Shelisha, Shah Ravi, Kharel Brinda
Tree Top Hospital Hulhumale Maldives.
Helping Hand Community Hospital Kathmandu Nepal.
Health Sci Rep. 2025 Jan 29;8(2):e70415. doi: 10.1002/hsr2.70415. eCollection 2025 Feb.
To determine the effect of prophylactic intravenous tranexamic acid on blood loss after vaginal delivery in women at low risk of postpartum hemorrhage.
Prospective randomized controlled study (RCT registration: researchregistry10144). Over the study duration of 12 months, a total of 226 parous women with singleton vaginal delivery at term pregnancy with cephalic presentation participated in the study. Participants with pre-existing medical complications and obstetric complications were excluded from the study. Additionally, patients with a previous history of thromboembolism and allergy to tranexamic acid were also excluded from the study. The study participants were divided into two groups based on the intervention considered. This was done with a computer-based random table generator. Group A received an intervention of 10 mL (1 g) of intravenous tranexamic acid while the other group received 10 mL of normal saline as a placebo immediately after delivery of the fetus. Blood loss was calculated by measuring the weights of blood-soaked gauze, gowns, sheets, and tampons before and after delivery. Hemoglobin and hematocrit were done before and 12 h after delivery.
Total number of participants were 226. The mean calculated blood loss and the mean measured blood loss was significantly less in Group A in comparison to Group B (379.17 ± 46.89 mL in Group A and 426.66 ± 58.45 mL in Group B, < 0.001), (247.88 ± 67.03 mL in Group A and 368.95 ± 58.54 mL in group B, < 0.001). Similarly, the mean decrease of hemoglobin after delivery was lower for Group A (1.45 ± 0.14) than for Group B (1.74 ± 0.24).
The use of prophylactic intravenous tranexamic acid is associated with reduced blood loss after vaginal delivery. Furthermore, research needs to be done.
确定预防性静脉注射氨甲环酸对产后出血低风险女性阴道分娩后失血的影响。
前瞻性随机对照研究（随机对照试验注册编号：researchregistry10144）。在为期12个月的研究期间，共有226例足月单胎头位阴道分娩的经产妇参与研究。患有既往内科并发症和产科并发症的参与者被排除在研究之外。此外，有血栓栓塞病史和对氨甲环酸过敏的患者也被排除在研究之外。根据所考虑的干预措施，将研究参与者分为两组。这是通过基于计算机的随机数字表生成器完成的。A组在胎儿娩出后立即接受10毫升（1克）静脉注射氨甲环酸的干预，而另一组接受10毫升生理盐水作为安慰剂。通过测量分娩前后血浸纱布、手术衣、床单和棉塞的重量来计算失血量。在分娩前和分娩后12小时检测血红蛋白和血细胞比容。
参与者总数为226例。与B组相比，A组计算出的平均失血量和测量出的平均失血量显著更低（A组为379.17±4^89毫升，B组为426.66±58.45毫升，P<0.001），（A组为247.88±67.03毫升，B组为368.95±58.54毫升，P<0.001）。同样，A组分娩后血红蛋白的平均下降幅度（1.45±0.14）低于B组（1.74±^24）。
预防性静脉注射氨甲环酸与阴道分娩后失血减少有关。此外，仍需开展研究。
