Effect of Prophylactic Tranexamic Acid on Peripartum Changes in Haemoglobin Concentration After Vaginal Delivery

This study aimed to evaluate the effect of prophylactic intravenous tranexamic acid on postpartum haemoglobin (Hb) concentration values compared to a control group.

This randomised controlled study took place from May to July 2023 and included parturients with no apparent risk for postpartum haemorrhage from the University of Calabar Teaching Hospital in Calabar, Nigeria. Participants were divided equally into 2 groups. Group A (intervention group) received 10 IU of intramuscular oxytocin along with 1,000 mg of intravenous tranexamic acid within 1 minute of vaginal delivery, while Group B (control group) received 10 IU of intramuscular oxytocin with 10 mL of sterile water. The primary outcome measure was the difference in admission and postpartum Hb concentration.

A total of 80 parturients were included in this study; 40 were allocated to each study arm. The demographic characteristics and admission parameters of the 2 groups showed no significant statistical difference (P >0.05). The mean postpartum Hb concentration was significantly higher in Group A compared to Group B (10.28 ± 0.59 mL versus 9.44 ± 0.62 mL; P <0.001). No major maternal side effects were reported in either group.

Compared to the placebo plus oxytocin, tranexamic acid plus oxytocin exhibited effectiveness in reducing postpartum Hb drop after vaginal delivery. Therefore, the use of tranexamic acid plus oxytocin is recommended as part of the active management of the third stage of labour.