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Background <p>Postpartum haemorrhage (PPH) is a leading cause of maternal mortality globally, disproportionately affecting low- and middle-income countries. Although tranexamic acid (TXA) is well-established for PPH treatment, robust evidence for prophylactic use in uncomplicated normal vaginal deliveries is limited. This study assessed the effectiveness of prophylactic intravenous TXA in reducing postpartum blood loss in women undergoing vaginal delivery.</p> Methods <p>In this prospective case-control study, 300 women with vaginal deliveries were randomized to receive either 1 g IV TXA immediately after delivery plus active management of the third stage of labour (<i>n</i> = 150) or active management alone (<i>n</i> = 150). Quantitative blood loss was measured. Haemoglobin and packed cell volume (PCV) were recorded pre-delivery and 24–48-h postpartum. Maternal vital signs, uterotonic use, and adverse events were documented. Independent t-tests compared groups; <i>p</i> &lt; 0.05 was considered significant.</p> Results <p>The TXA group had significantly lower mean total blood loss (378.1 ± 52.5&#xa0;mL) compared to controls (468.2 ± 52.5&#xa0;mL; <i>p</i> &lt; 0.01). Reductions in haemoglobin (−0.9&#xa0;g/dL vs.−1.4&#xa0;g/dL; <i>p</i> &lt; 0.01) and PCV (−1.7% vs. −3.0%; <i>p</i> &lt; 0.01) were smaller in the TXA group. Postpartum haemodynamic stability was better maintained, with no increase in adverse events or thromboembolic complications.</p> Conclusion <p>Prophylactic IV TXA with standard uterotonics significantly reduces postpartum blood loss in low-risk vaginal deliveries without added safety risks. Its affordability and ease of administration support inclusion in PPH prevention strategies, especially in resource-limited settings.</p>

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Efficacy of Prophylactic Tranexamic Acid in Normal Vaginal Delivery: A Prospective Case–Control in a Tertiary Care Centre in India

  • 期刊论文

  • 发表日期：

    2025年12月6日

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  • Sana Ahmad,
  • Kusum Lata,
  • Keerti Singh,
  • Shikha Verma,
  • Suraiya Khanam

摘要

Background

Postpartum haemorrhage (PPH) is a leading cause of maternal mortality globally, disproportionately affecting low- and middle-income countries. Although tranexamic acid (TXA) is well-established for PPH treatment, robust evidence for prophylactic use in uncomplicated normal vaginal deliveries is limited. This study assessed the effectiveness of prophylactic intravenous TXA in reducing postpartum blood loss in women undergoing vaginal delivery.

Methods

In this prospective case-control study, 300 women with vaginal deliveries were randomized to receive either 1 g IV TXA immediately after delivery plus active management of the third stage of labour (n = 150) or active management alone (n = 150). Quantitative blood loss was measured. Haemoglobin and packed cell volume (PCV) were recorded pre-delivery and 24–48-h postpartum. Maternal vital signs, uterotonic use, and adverse events were documented. Independent t-tests compared groups; p < 0.05 was considered significant.

Results

The TXA group had significantly lower mean total blood loss (378.1 ± 52.5 mL) compared to controls (468.2 ± 52.5 mL; p < 0.01). Reductions in haemoglobin (−0.9 g/dL vs.−1.4 g/dL; p < 0.01) and PCV (−1.7% vs. −3.0%; p < 0.01) were smaller in the TXA group. Postpartum haemodynamic stability was better maintained, with no increase in adverse events or thromboembolic complications.

Conclusion

Prophylactic IV TXA with standard uterotonics significantly reduces postpartum blood loss in low-risk vaginal deliveries without added safety risks. Its affordability and ease of administration support inclusion in PPH prevention strategies, especially in resource-limited settings.