الفهرس 
Primary Postpartum HemorrhageOnly 14 pages are availabe for public view
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Abstract
Tranexmic Acid and reducing blood loss after Vaginal Delivery:
A randomized controlled trial
Postpartum hemorrhage (PPH) is commonly defined as blood loss exceeding 500 ml following vaginal birth and 1000 ml following cesarean. Estimates of PPH incidence in the literature vary widely, from 3% to 15% of deliveries. About one in five of these hemorrhages progresses to a severe form that may endanger the mother’s life or at least her future fertility and exposes her to the risks of transfusion, surgery, and intensive care. Tranexamic acid (TXA) is a potent antifibrinolytic agent that exerts its effect by blocking lysine binding sites on plasminogen molecules and has the potential to enhance the effectiveness of the patient’s own hemostatic mechanisms. Consequently, clot breakdown (fibrinolysis) is inhibited and bleeding is reduced. This study aims to assess the efficacy of addition of Tranexmic Acid (TXA) to the active management of the third stage of labor (AMTSL) in reducing the amount of blood loss during normal vaginal delivery. Primary post-partum hemorrhage (PPH) is defined as blood loss greater than or equal to 500 ml within 24 hours after birth, while severe PPH is blood loss greater than or equal to 1000 ml within 24 hours. Patients were randomized and divided into 2 groups: group A (study group) included 80 patients that received the standard AMTSL + Tranexmic Acid (Kapron, Amoun, Egypt 1 gm IV) in the 2 min after baby`s delivery. group B (control group) included 80 patients that received the standard AMTSL+ placebo treatment similar to Tranexmic acid (Saline). Base line characteristics of patients in both groups were matched as there was no significant difference between the two studied groups as regarding demographic data “age, gestational age or BMI”, obstetric history “gravidity, parity or abortion” and the pre-delivery level of hemoglobin and hematocrit. The results of the study denotes that addition of tranexmic acid to the active management of third stage of labor can reduce the amount of blood loss during delivery and thus decrease the incidence of primary postpartum hemorrhage.
Keywords: Tranexmic Acid, fibrinolysis, Saline,