To study the role of tranexamic acid in the management of menorrhagia

Authors

  • U. S. Hangarga Department of Obstetrics and Gynecology, Navodaya Medical College, Raichur, Karnataka, India
  • Rita D. Department of Obstetrics and Gynecology, SDM Medical College, Dharwad, Karnataka, India
  • Reshma Reddy Edula Department of Obstetrics and Gynecology, Navodaya Medical College, Raichur, Karnataka, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20163833

Keywords:

Haemoglobin, Tranexamic acid, Menorrhagia, Hypertension

Abstract

Background: Heavy menstrual bleeding is a significant case of morbidity during the reproductive years. Approximately 30% of women complain of menorrhagia and it is the main presenting problem of women consulting a gynaecologist. In addition, excessive menstrual bleeding accounts for about two-thirds of all hysterectomies. This amount of blood loss can cause disturbance of the woman’s social, occupational or sexual life, as well as medical risks such as chronic iron deficiency anemia. Objective of the study was to determine if tranexenic acid can effectively and safely reduce menstrual blood loss in menorrhagia.

Methods: 100 cases selected for the study who complained of regular long/ heavy menstrual bleeding more than 7 days or blood loss more than 80ml, who are at the age of 20-45 years. This study includes measurement of menstrual blood loss, duration of bleeding, number of sanitary pad usage for two menstrual cycles who complained of regular excessive menstrual bleeding using pictogram and taken history of IUCD insertion. Abdominal, gyanecological examination and ultra sound has been done to rule out any pelvic pathology. Drug Tranexamic acid 500mg QID were given to the patients who had mean menstrual blood loss of more than 80ml based on assessment in the previous two menstrual cycles.

Results: The total study shows the effect of drugs on the amount of bleeding is 41.6% (P-value <0.05), there is significant reduction is seen in number of sanitary pad usage from 5.44 to 3.96 (P- value <0.05) and there is significant reduction in duration of bleeding. There are minimal gastrointestinal side effects, and there is 32% discontinuation of treatment in our study as patient is not satisfied.

Conclusions: Treatment with tranexamic acid could potentially improve quality of life of women. It is also effective treatment for menorrhagia caused by IUCD. Current clinical evidence concludes that size and type of fibroid has significant influence on effect of treatment. Tranexamic acid has been doc umented and found to have no effect on uterus with adenomyosis and endometrial polyp

References

Afkhami-Ardekani M, Rashidi M. Iron status in women with and without gestational diabetes mellitus. Journal of Diabetes and its Complications. 2009;23(3):194-8.

Abdulraheem NM. Protection of women’s rights under the nigerian plural legal system: faculty of law, university of ilorin; 2010.

Tyndall JA, Okoye V, Elumelu F, Dahiru A, Pariya HB. Vitamin A and iron deficiency in pregnant women, lactating mothers and their infants in Adamawa State, Nigeria: a prospective cohort study. American Journal of Food and Nutrition. 2012;2:14-20.

Villar J, Ba'aqeel H, Piaggio G, Lumbiganon P, Belizán JM, Farnot U. WHO antenatal care randomised trial for the evaluation of a new model of routine antenatal care. The Lancet. 2001;357(9268):1551-64.

Osgerby J, Gadd T, Wathes D. The effects of maternal nutrition and body condition on placental and foetal growth in the ewe. Placenta. 2003;24(2):236-47.

Kalimbira A, Mtimuni B, Chilima D. Maternal knowledge and practices related to anaemia and iron supplementation in rural Malawi: A cross-sectional study. African Journal of Food, Agriculture, Nutrition and Development. 2009;9(1):550-64.

Malek A, Sager R, Eckardt KU, Bauer C, Schneider H. Lack of transport of erythropoietin across the human placenta as studied by an in vitro perfusion system. Pflügers Archiv. 1994;427(1-2):157-61.

Dinga LA. Factors associated with adherence to Iron/Folate supplementation among pregnant women attending antenatal clinic at Thika District Hospital in Kiambu County, Kenya: University of Nairobi; 2013.

Khan KS, Wojdyla D, Say L, Gülmezoglu AM, Van Look PF. WHO analysis of causes of maternal death: a systematic review. The lancet. 2006;367(9516):1066-74.

Jasti S, Siega-Riz AM, Cogswell ME, Hartzema AG, Bentley ME. Pill count adherence to prenatal multivitamin/mineral supplements use among low-income women. The Journal of nutrition. 2005;135(5):1093-101.

Awusi V, Anyanwu E, Okeleke V. Determinants of antenatal care services utilization in Emevor Village, Nigeria. Benin Journal of Postgraduate Medicine. 2009;11(1).

Fiedler J, DAgostino A, Sununtnasuk C. A rapid initial assessment of the distribution and consumption of ironâ folic acid tablets through antenatal care in Nepal; 2015.

Idowu O, Mafiana C, Dopu S. Anaemia in pregnancy: a survey of pregnant women in Abeokuta, Nigeria. African health sciences. 2005;5(4):295-9.

Carpenter CJ. A meta-analysis of the effectiveness of health belief model variables in predicting behavior. Health communication. 2010;25(8):661-9.

Ezzati M, Lopez AD, Rodgers A, Vander Hoorn S, Murray CJ. Selected major risk factors and global and regional burden of disease. The Lancet. 2002;360(9343):1347-60.

Ugwu E, Olibe A, Obi S, Ugwu A. Determinants of compliance to iron supplementation among pregnant women in Enugu, Southeastern Nigeria. Nigerian journal of clinical practice. 2014;17(5):608-12.

Bukar M, Audu B, Sadauki H, Elnafaty A, Mairiga A. Prevalence of iron deficiency and megaloblastic anaemia at booking in a secondary health facility in north eastern Nigeria. Nigerian Medical Journal. 2009;50(2):33.

Finlayson K, Downe S. Why do women not use antenatal services in low-and middle-income countries? A meta-synthesis of qualitative studies. 2013;10(1):e1001373.

Kennedy GL, Pedro MR, Seghieri C, Nantel G, Brouwer I. Dietary diversity score is a useful indicator of micronutrient intake in non-breast-feeding Filipino children. The Journal of nutrition. 2007;137(2):472-7.

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Published

2016-12-14

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Original Research Articles