Table 5.
PPH: results of clinical studies with tranexamic acid in obstetrics
| Authors | N | Method | Results |
|---|---|---|---|
| Vaginal delivery | |||
| Dulcoy-Bouthers et al. [40] | 144 | RCT, double-blind 4 g TXA + 1 g/h in 6 h = 10 g |
Bleeding duration ↓ Progression to severe PPH (>800 ml) ↓ |
| Yang et al. [41] | 400 | RCT (prospective, double-blind) 0.5 g vs 1.0 g TXA vs. PAMBA* |
Total blood loss ↓ |
| Gungorduk et al. [42] | 454 | RCT TXA 1.0 g vs. placebo |
Blood loss ↓ Progression to severe PPH (>500 ml) ↓ |
| Bouet et al. [43] | 289 | Retrospective single centre analysis of policy before and after use of high dose TXA 10 g | No difference in blood loss |
| Cesarean delivery | |||
| Goswami et al. [44] | 90 | RCT (prospective, double-blind) 10 mg/kg TXA in 20 min, then 10 vs. 15 mg/kg TXA vs placebo |
Total blood loss in both TXA groups ↓ significantly less with 15 mg/kg |
| Gai et al. [45] | 180 | RCT (multi centre, prospective, randomized controlled) 1 g TXA over 5 min, 10 min before CS vs not |
Blood loss until 2 h after delivery ↓ |
| Abdel Aleem et al. [46] | 740 | RCT (Single centre, open, controlled) 1 g TXA over 10 min, 10 min before CS vs. not |
Blood loss until 2 h after delivery ↓ Hemoglobin decline ↓ |
| Sekhavat et al. [47] | 90 | RCT (prospective, randomized, double-blind) 1 g TXA over 10 min, 10 min before CS vs. not |
Blood loss until 2 h after delivery ↓ Hemoglobin decline ↓ |
| Halder et al. [48] | 100 | Case-control study TXA before CS vs not |
Blood loss until 2 days postpartum ↓ Hemoglobin decline ↓ |
| Movafegh et al. [49] | 100 | RCT (prospective, double-blind, randomized, controlled) 10 mg/kg TXA vs placebo |
Blood loss until 2 h postpartum ↓ Hemoglobin decline ↓ |
| Sentürk et al. [50] | 223 | RCT (prospective, double-blind, placebo controlled) 10 mg/kg for 5 min, 10 min before CS vs placebo |
Intra- and postoperative blood loss ↓ |
| Xu et al. [51] | 174 | Randomized case-control study 10 mg/kg TXA before CS or not |
Blood loss until 2 h postpartum ↓ Progression to PPH ↓ |
| Gohel et al. [52] | 100 | Randomized, prospective case-control study 1 g TXA over 5 min |
Blood loss until 2 h postpartum ↓ |
| Shahid et al. [53] | 74 | RCT (prospective, randomized, double-blind) 1 g TXA |
Intraoperative blood loss ↓ |
| Gungorduk et al. [54] | 660 | RCT (prospective, double-blind, placebo controlled) 1 g TXA |
Intraoperative blood loss ↓ |
↓ = difference to placebo significant
CS cesarean section, RCT randomized clinical trial, PPH postpartum hemorrhage, PAMBA para-aminomethylbenzoic acid, TXA tranexamic acid