Cesarean section, or C-section, is a commonly performed surgical procedure that involves the delivery of a baby through incisions made in the mother’s abdomen and uterus. While C-sections are generally safe, they do come with some risks, including hemorrhage or excessive bleeding. To prevent this complication, the use of tranexamic acid has gain popularity in recent years. However, a new study suggests that this medication may not be as effective as previously thought in preventing hemorrhage after a C-section. In this article, we will explore what tranexamic acid is, how it works, and why the latest research findings are important for women and their healthcare providers.
Prophylactic use of tranexamic acid (TXA) during cesarean delivery does not lower the risk of maternal death or blood transfusion, according to a recent randomized trial conducted in 31 US hospitals. The trial involved 11,000 women and the primary outcome of maternal death or blood transfusion was recorded in 3.6% of the TXA group and 4.3% of the placebo group. Intraoperative blood loss of over 1 liter occurred in 7.5% of the TXA group and 8% of the placebo group. TXA is used to decrease perioperative bleeding in surgeries such as heart operations and liver transplants but has not previously been studied in the context of obstetric hemorrhage. The previous trial had recommended its early use for women with obstetric or postpartum hemorrhage. The recent trial suggests that prophylactic use of TXA does not decrease the risk of blood products and there is not enough data to recommend its use to prevent obstetric hemorrhage as it does not lead to clinically significant improvements. TXA was administered after umbilical cord clamping, and the benefit of earlier administration (before incision), if any, is unknown. The study group is currently conducting a new trial named, the OPTIMUM OB-TXA trial to study the optimal timing, route, and dose of TXA prior to umbilical cord clamping.
While tranexamic acid has been widely used as a potential solution to reduce bleeding and hemorrhage after C-sections, recent research suggests that it might not be as effective as we once thought. As always, medical professionals must be cautious and keep exploring alternative methods to address this issue. The search for innovative and effective measures to prevent hemorrhage continues, and we must be attentive to any new findings that could help tackle this issue in the future. Until then, it is vital for healthcare providers to closely monitor patients during and after caesarian sections to maintain their health and wellbeing.
