A comparative study on placebo and trenaxamic acid for the prophylaxis is of post-partum hemorrhage: a randomised double-blind control study

S. Parveen, G. Kesava Chandra, K. Ravindra Reddy, A. V. Kavya Sree, M. Varalakshmi, R. Gayathri, V. Bhuvana Chandra, P. Venkata Ramana


Background: Obstetric haemorrhage accounts for 20-25% of maternal mortality and morbidity. Anti-fibrinolytics are being widely used in field of surgery. It is also used to reduce heavy menstrual blood loss. The aim of this study was to analyse the effectiveness of TXA in reducing blood loss during normal vaginal delivery.

Methods: The randomized double-blind control study was done in the Labour ward. It was conducted on 100 women undergoing Normal vaginal delivery. They were allocated to either Study or Control group by randomization. TXA was given during the Third stage of delivery in study group in addition to the routine care whereas the control group had routine care alone. Blood loss was measured in both groups by bag method.

Results: The significant of reduction in blood loss calculated from placental delivery to 2hrs. 141.9 ml in study group versus 270.4 ml in control group. Among primi patients, the control group average blood loss was 325ml, the study group avg blood loss was 169ml. Among G2 patients, the control group average blood loss was 248.5ml. The study group average blood loss was 128.25ml. Among G3 patients, the control group average blood loss was 203ml, the study group average blood loss was 115ml.

Conclusions: TXA significantly reduced the amount of blood loss during normal vaginal delivery. Thus, TXA can be used safely and effectively in subjects undergoing normal vaginal delivery.


Normal vaginal deliveries, Postpartum hemorrhage, Prevention, Randomization, Tranexamic acid, Treatment

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L. Sentilhes. Tranexamic acid for the prevention and treatment of post-partum haemorrhage. BJA 2015; 114 (4): 576-87.

Anderson J, Etches D, Smith D. Postpartum haemorrhage. In: Damos JR, Eisinger SH, eds. Advanced Life Supportin Obstetrics (ALSO) provider course manual.Kansas: American Academy of Family Physicians, 2000;1-15.

Rouse DJ, Leindecker S, Landon M, Bloom SL, Varner MW, Moawad AH, et al. The MFMU Cesarean Registry: uterine atony after primary cesarean delivery. Am J Obstetr Gynecol. 2005;193(3):1056-60.

Magann EF, Evans S, Hutchinson M, Collins R, Howard BC, Morrison JC. Postpartum hemorrhage after vaginal birth: an analysis of risk factors. S Med J2005;98:419-22.

Weeks AD, Mirembe FM. The retained placenta – new insights into an old problem. Eur J Obstet Gynecol Reprod Biol. 2002;102:109-10.

Tara V Shanbhag; Pharmacology; 2nd edition; Elseveir.361-3.

K.D. Tripathi; essentials of Medical Pharmacology; 7th edition; Jaypee; 189-94,331-2.

Joseph T Dipiro. American Hospital formulary Services; 2nd edition; Lippincott Williams and WIllkins; 560.

Shobha Misra. Randomized double blind placebo control studies, the “Gold Standard” in intervention based studies. Indian J Sex Transm Dis AIDS. 2012; 33(2): 131-4.

Chunbo Li, Yuping Gong, Lingling Dong MD, Bingying Xie MD, Zhiyuan Dai MD. Is prophylactic tranexamic acid administration effective and safe for postpartum hemorrhage prevention? 2016; 96:1.

Gungorduk K, Asıcıoğlu O, Yıldırım G, Ark C, Tekirdağ Aİ, Besımoglu B. Can intravenous injection of tranexamic acid be used in routine practice with active management of the third stage of labor in vaginal delivery? A randomized controlled study. Am J Perinatol. 2013;30(05):407-14.

Ducloy-Bouthors AS, Jude B, Duhamel A, Broisin F, Huissoud C, Keita-Meyer H, et al. High-dose tranexamic acid reduces blood loss in postpartum haemorrhage. Critical Care. 2011;15(2):R117.

Novikova N, Hofmeyr GJ, Cluver C. Tranexamic acid for preventing postpartum haemorrhage. Cochrane Database of Systematic Reviews. 2015(6).

Loïc Sentilhes. Tranexamic acid for preventing postpartum hemorrhage after vaginal delivery: a multicenter randomized, double-blind, placebo-controlled trial J. 2009;34-39.

Esen UI. Re: The prevention and treatment of postpartum haemorrhage: what do we know, and where do we go next?. BJOG: Inter J Obstetr Gynaecol. 2015;122(8):1145-6.

Ng WC, Jerath A, Wasowicz M. Tranexamic acid: a clinical review. Anaesthesiol Intensive therapy. 2015;47(4):339-50.

Mayur G, l Purvi P, Ashoo G, Pankaj D, Efficacy of tranexamic acid in decreasing blood loss during and after cesarean section: A randomized case controlled prospective study. J Obstet Gynecol India. 2007;5(3):227-30.