OC 51.4 - Efficacy and Safety of pre-operative prophylactic intravenous tranexamic Acid on Postpartum Hemorrhage: A Meta-Analysis of 18,649 Patients.

Tuesday, June 25, 2024

10:15 – 10:30 ICT

Room: Ballroom B1

Presenting Author(s)

Nada M. Al-dardery, MBBCh

Intern doctor
Al-Fayoum University Hospital, Fayoum, Egypt.
Fayoum, Al Fayyum, Egypt

Co-Author(s)

OA

Omar Ahmed Abdelwahab

Internship doctor
Al Hussein University Hospital, Cairo, Egypt
Cairo, Al Qahirah, Egypt
MA

Mohamed Abouzid

PhD fellow
Department of Physical Pharmacy and Pharmacokinetics, Poznan University of Medical Sciences, Poznan, Poland
Poznan, Wielkopolskie, Poland
KA

Khaled Albakri

Medical Student
Faculty of Medicine, The Hashemite University, Zarqa, Jordan
Zarqa, Az Zarqa', Jordan
AE

Ali Elkhadragy

Medical doctor
Faculty of medicine, Alexandria university, Alexandria, Egypt
Alexandria, Al Iskandariyah, Egypt
BK

Basant E. Katamesh

Research fellow
General Internal Medicine, Mayo clinic, Rochester, USA
Tanta, Al Gharbiyah, Egypt
RH

Rawan Hamamreh

Medical Student
Faculty of Medicine, The Hashemite University, Zarqa, Jordan
Zarqa, Az Zarqa', Jordan
AM

Ahmed B. Mohd

Medical Student
Faculty of Medicine, The Hashemite University, Zarqa, Jordan
Zarqa, Az Zarqa', Jordan
AA

Ahmed Abdelaziz

Medical intern
Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Cairo, Al Qahirah, Egypt
AK

Abdulrhman Khaity

Internship doctor,
Al Hussein University Hospital, Cairo, Egypt
Khartoum, Khartoum, Sudan

Background: Postpartum hemorrhage (PPH) is a significant complication following childbirth and is recognized as a leading contributor to maternal mortality globally. The crucial approach to decreasing PPH occurrences involves the use of the antifibrinolytic agent as tranexamic acid for preventive measures.

Aims: In this meta-analysis, our objective was to provide a current review of clinical evidence on the effectiveness and safety of TXA in preventing PPH.

Methods: We conducted a comprehensive literature review spanning from the inception of databases such as PubMed, Scopus, Web of Science, Google Scholar, and the Cochrane Library up to December 2022. Our inclusion criteria comprised RCTs that compared TXA with a placebo among pregnant women. All pertinent outcomes, including total blood loss and change in hemoglobin levels, were synthesized as odds ratios (OR) or mean differences (MD) in the meta-analysis models using STATA 17 MP.

Results: We included 59 RCTs (18,649 patients) in this meta-analysis. For cesarean birth, TXA demonstrated superiority over the placebo in reducing total blood loss (MD= -2.11 mL, 95%CI [-3.09 to -1.14], P < 0.001), and occurrence of nausea or/and vomiting (OR = 1.36, 95%CI [1.07 to 1.74], P = 0.01). For vaginal birth, the prophylactic use of TXA correlated with decreased total blood loss but an increased occurrence of nausea and/or vomiting (MD= -0.89 mL, 95%CI [-1.47 to -0.31], OR = 2.36, 95%CI [1.32 to 4.21], P = 0.02), respectively. However, no significant differences between the groups were observed in terms of changes in hemoglobin during vaginal birth (MD = 0.20 g/dl, 95%CI [-0.07 to 0.48], P = 0.15).

Conclusion(s): The findings of this meta-analysis indicate the effectiveness of administering TXA for women undergoing either cesarean or vaginal delivery, leading to a reduction in total blood loss and a decreased incidence of PPH. Further clinical trials are recommended to test its efficacy on high-risk populations.