Cesarean delivery, also known as a C-section, is a common surgical procedure performed to deliver infants when vaginal delivery is not possible or poses risks to the mother or baby. One of the major complications that can arise from a C-section is postpartum hemorrhage, which is excessive bleeding following childbirth. To prevent such bleeding, a drug called Tranexamic acid is often used. However, recent research suggests that Tranexamic acid may not be effective in preventing maternal hemorrhage after cesarean delivery. In this article, we will explore the findings of this research in detail.
The National Institutes of Health has funded a study that has found that Tranexamic acid is no more effective than a placebo in reducing the need for blood transfusion or in preventing maternal death in patients with an increased risk for excessive bleeding due to cesarean delivery. Tranexamic acid serves to slow the natural breakdown of blood clots and had been seen as a promising drug for the reduction of excessive bleeding after giving birth, also known as postpartum hemorrhage. The study was led by Luis D. Pacheco and colleagues of the University of Texas Medical Branch and was published in the New England Journal of Medicine. The National Institute of Child Health and Human Development provided funding for the study.
Previous studies had theorized that since Tranexamic acid helped to prevent the breakdown of blood clots, the drug might slow blood loss and reduce the risk of postpartum hemorrhage. Test findings revealed that Tranexamic acid had been found to be effective among women experiencing postpartum hemorrhage. Researchers sought to establish the effectiveness of the drug for patients undergoing cesarean delivery with no hemorrhaging at the time of treatment. Thus, 11,000 patients were assigned by researchers to receive either intravenous Tranexamic acid or a placebo after umbilical cord clamping at the time of cesarean delivery. The study included both women who had undergone a scheduled cesarean delivery and unscheduled ones.
The results were reported as the primary outcome of events that might arise after postpartum hemorrhage, the need for a transfusion of red blood cells or death. These events occurred in 3.6% of the Tranexamic acid group (201 patients) and 4.3% of the placebo group (233 patients), a difference that was not statistically significant. A death was recorded in the placebo group, and there were no deaths in the Tranexamic acid group. There was no significant difference between the groups concerning the secondary outcome of estimated blood loss of more than 1 liter during the procedure: 7.3% in the Tranexamic acid group and 8% in the placebo group.
However, the study produced an interesting finding as patients who received Tranexamic acid were less likely to need additional medical or surgical interventions to treat postpartum hemorrhage in comparison to the placebo group (16.1% versus 18%) and had a lower drop in red blood cell count after cesarean delivery (1.8 grams per deciliter versus 1.9 grams per deciliter).
While Tranexamic acid had previously been found effective in reducing postpartum hemorrhage, the study’s results indicate that Tranexamic acid may not be effective in reducing the need for blood transfusion or maternal death in patients with an increased risk of excessive bleeding due to cesarean delivery. The results of the study are therefore vital to medical practitioners in such conditions.
In conclusion, while Tranexamic acid may be effective in reducing blood loss and preventing hemorrhage in other medical procedures, it does not appear to show significant benefit in preventing maternal hemorrhage after cesarean delivery. While further research may be needed to fully understand its potential benefits in this area, clinicians and expectant mothers should be aware of its limitations in preventing postpartum bleeding. It is important for medical professionals to continue exploring effective and safe strategies for managing bleeding during and after cesarean delivery to ensure the best possible outcomes for mothers and babies.
