Tranexamic acid for the prevention of postpartum hemorrhage and decreasing blood loss after vaginal delivery in high-risky parturient: A double-blind randomized controlled trial

Background and objective: The purpose of this study was to examine the effectiveness of Tranexamic acid administered in the third stage of labor to reduce vaginal blood loss and prevent postpartum hemorrhage in women with high-risk factors for postpartum Hemorrhage. Methods: A double-blind randomized placebo-controlled trial with two parallel groups was conducted in women scheduled to undergo vaginal delivery at the Maternity Teaching Hospital, Erbil city, Kurdistan Region, Iraq. The women were randomly assigned to receive tranexamic acid (97 women) or placebo (99 women) immediately after fetal delivery in the third stage of labor. The vaginal blood loss and the time from fetal to placental delivery were measured. Results: The mean blood loss in the placebo group (Group 1) was 354.5 gram, which was considerably greater than the mean blood loss in the tranexamic group (Group 2), which was 284.4 gram. The incidence of postpartum hemorrhage (blood loss of ≥500 ml.) and (blood loss of ≥250 ml.) was significantly higher in G1 than G2. The length of the third stage of labor lasted 10.28 minutes in G1, which was longer than in G2, which lasted 7.82 minutes. Oxytocin was given to both groups as an active management of the third stage of labor. Conclusion: In this single-center study, women with risk factors for postpartum hemorrhage who received tranexamic acid had lower postpartum blood loss and a shorter time for placental delivery than those women who received placebo. Larger multicenter randomized clinical trials are needed to generalize these findings.