Table I.
Characteristics and main results of the 18 randomised controlled trials on the use of tranexamic acid for the prevention of obstetric haemorrhage.
| First Author yearref. | Cases (IVTA/C) | Age, years1 | IVTA dose | Controls | Post-partum blood loss, mL1 | PPH onset | RBC transfusion | TA-related SAEs |
|---|---|---|---|---|---|---|---|---|
| Gai 200425 | 91/89 | IVTA: 29.71 (4.18) | 1 g 10 min before CS | No treatment | IVTA: 359.29 (152.02)2 | IVTA: 22/913 | NR | IVTA: 0/91 |
| C: 29.75 (4.01) | C: 439.36 (191.48)2 | C: 35/893 | C: 0/89 | |||||
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| Sekhavat 200926 | 45/45 | IVTA: 26.2 (4.7) | 1 g 10 min before CS | 5% glucose | IVTA: 28.02 (5.53)4 | NR | NR | IVTA: 0/45 |
| C: 27.1 (4.1) | C: 37.12 (8.97)4 | C: 0/45 | ||||||
|
| ||||||||
| Gungorduk 201127 | 330/330 | IVTA: 26.3 (3.5) | 1 g 10 min before CS | 5% glucose | IVTA: 499.9 (206.4)5 | IVTA: 7/3306 | IVTA: 2/330 | IVTA: 0/330 |
| C: 26.6 (3.6) | C: 600.7 (215.7)5 | C: 19/3306 | C: 7/330 | C: 0/330 | ||||
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| Movafegh 201128 | 50/50 | IVTA: 27.0 (3.4) | 10 mg/kg 20 min before SA | Normal saline | IVTA: 262.5 (39.6)2 | NR | NR | IVTA: 0/50 |
| C: 27.6 (4.1) | C: 404.7 (94.4)2 | C: 0/50 | ||||||
|
| ||||||||
| Xu 201329 | 88/86 | IVTA: 26.7 (3.7) | 10 mg/kg 20 min before SA | Normal saline | IVTA: 379.2 (160.1)2 | IVTA: 19/887 | IVTA: 8/88 | IVTA: 2/88 |
| C: 27.1 (4.1) | C: 441.7 (189.5)2 | C: 28/867 | C: 19/86 | C: 2/86 | ||||
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| Shahid 201330 | 38/36 | IVTA: 24.18 (3.93) | 1 g 10 min before CS | Normal saline | IVTA: 356.44 (143.2)2 | NR | IVTA: 3/38 | IVTA: 0/38 |
| C: 24.89 (4.16) | C: 710.22 (216.72)2 | C: 12/36 | C: 0/36 | |||||
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| Goswami 201331 | 60/30 | IVTA: 23.6 (2.5) | 10 or 15 mg/kg 20 min before skin incision | 5% glucose | IVTA: 261.17 (56.78)–376.83 (31.96)8 | IVTA: 0/606 | IVTA: 0/60 | IVTA: 0/60 |
| C: 24.3 (2.6) | C: 527.17 (88.67)8 | C: 0/306 | C: 2/30 | C: 0/30 | ||||
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| Senturk 201332 | 101/122 | IVTA: 30.2 (6.83) | 1 g 10 min before CS | 5% glucose | IVTA: 272.05 (143.23) | NR | IVTA: 0/101 | IVTA: 0/101 |
| C: 29.22 (6.93) | C: 346.87 (189.49) | C: 0/122 | C: 0/122 | |||||
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| Abdel-Aleem 201333 | 373/367 | IVTA: 26.34 (5.16) | 1 g 10 min before CS | No treatment | IVTA: 241.61 (126.02)2 | IVTA: 2/3736 | NR | IVTA: 0/373 |
| C: 26.62 (5.05) | C: 510.66 (144.52)2 | C: 2/3676 | C: 0/367 | |||||
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| Ghosh 201434 | 70/70 | IVTA: 25.94 (3.78) | 1 g 10 min before CS | Normal saline | IVTA: 48.06 (8.20)4 | NR | IVTA: 0/70 | IVTA: 0/70 |
| C: 26.04 (3.39) | C: 76.01 (6.21)4 | C: 3/70 | C: 0/70 | |||||
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| Singh 201435 | 100/100 | IVTA: 25 (1.46) | 1 g 20 min before CS | No treatment | IVTA: 270.05 (30.88)9 | NR | NR | IVTA: 0/100 |
| C: 30 (1.24) | C: 510.45 (30.34)9 | C: 0/100 | ||||||
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| Yehia 201436 | 106/106 | IVTA: 28.4 (4.9) | 1 g 20 min before CS | Normal saline | IVTA: 369.5 (198.0)9 | IVTA: 33/1063 | IVTA: 0/106 | IVTA: 0/106 |
| C: 28.6 (4.7) | C: 606.8 (193.0)9 | C: 67/1063 | C: 2/106 | C: 0/106 | ||||
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| Gobbur 201437 | 50/50 | IVTA: 23.62 (3.43) | 1 g 20 min before CS | Normal saline | IVTA: 360.9 (110.3)2 | IVTA: 6/507 | NR | IVTA: 0/50 |
| C: 24.5 (3.98) | C: 443.0 (88.55)2 | C: 15/507 | C: 0/50 | |||||
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| Ramani 201438 | 60/60 | IVTA: 24.9 (3.9) | 1 g 10 min before CS | Normal saline | IVTA: 222.07 (97.02)2 | NR | IVTA: 2/60 | IVTA: 0/60 |
| C: 24.4 (3.7) | C: 274.5 (179.2)2 | C: 6/60 | C: 0/60 | |||||
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| Ahmed 201539 | 62/62 | IVTA: 28.6 (5.9) | 10 mg/kg 5 min before CS | Normal saline | IVTA: 391.0 (48.5)2 | NR | NR | IVTA: 0/62 |
| C: 26.9 (5.2) | C: 596.7 (38.02)2 | C: 0/62 | ||||||
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| Maged 201540 | 100/100 | IVTA: 24.9 (4.6) | 1 g 20 min before CS | Normal saline | IVTA: 459.4 (75.4) | IVTA: 0/1006 | NR | IVTA: 0/100 |
| C: 25.3 (4.7) | C: 700.3 (143.9) | C: 6/1006 | C: 0/100 | |||||
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| Lakshmi 201641 | 60/60 | IVTA: 26.77 (2.81) | 1 g 20 min before CS | No treatment | IVTA: 347.17 (108.6)9 | IVTA: 2/607 | IVTA: 0/60 | IVTA: 0/60 |
| C: 26.82 (2.8) | C: 517.72 (150.0)9 | C: 36/607 | C: 0/60 | C: 0/60 | ||||
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| Sujata 201642 | 30/30 | IVTA: 29.4 (4.16) | 1 g 15 min before CS | Normal saline | IVTA: 432 (337–497)5,10 | IVTA: 0/306 | IVTA: 1/30 | IVTA: 0/30 |
| C: 30.27 (4.31) | C: 819 (663–1001)5,10 | C: 7/306 | C: 4/30 | C: 0/30 | ||||
IVTA: intravenous tranexamic acid; C: controls; SD: standard deviation; min: minutes; CS: caesarean section; SAEs: severe adverse events; RBC: red blood cell transfusion; NR: not reported; PPH: post-partum haemorrhage; SA: spinal anaesthesia.
1
Mean (standard deviation);
2
measured from placental delivery to 2 hours post-partum;
3
defined as blood loss >400 mL;
4
measured from the end of cesarean section to 2 hours post-partum;
5
measured from the skin incision to 48 hours post-partum;
6
defined as blood loss >1,000 mL;
7
defined as blood loss >500 mL;
8
measured from placental delivery to 24 hours post-partum;
9
measured from placental delivery to the end of caesarean section;
10
median (interquartile range).