title: Effects of tranexamic acid on the coagulation and fibrinolytic systems in pregnancy complicated by placental bleeding.
abstract: Treatment with the fibrinolytic inhibitor tranexamic acid was investigated in 12 women with vaginal bleeding in the second half of pregnancy. The aim of the therapy was to accelerate haemostasis in the uteroplacental circulation and to prevent further bleeding at the placental site. Tranexamic acid 1 g 8-hourly was given for 7 days. Serial investigations of coagulation and fibrinolysis were carried out. Plasma fibrinolytic activity, plasminogen, antiplasmin and platelet count significantly decreased during treatment, while antithrombin III and factor VIII related antigen showed a significant increase. Plasma tranexamic acid levels ranged from 5 mg/l to 17 mg/l. Two patients on treatment at the time of delivery had plasma tranexamic acid levels of 9 mg/l and 12 mg/l detected in the umbilical cord venous blood. No adverse effects were detected in any of the mothers and all 12 were delivered of live born infants. Tranexamic acid may have a therapeutic role in accelerating haemostasis in the uteroplacental circulation and thereby reducing the adverse effects of bleeding at the placental site.
mesh_terms: D001777:Blood Coagulation / Q000187:drug effects*; D003509:Cyclohexanecarboxylic Acids / Q000494:pharmacology*; D005260:Female; D005333:Fetus / Q000187:drug effects; D005342:Fibrinolysis / Q000187:drug effects*; D006801:Humans; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000097:blood / Q000188:drug therapy*; D013997:Time Factors; D014148:Tranexamic Acid / Q000494:pharmacology* / Q000627:therapeutic use
chemical_list: D003509:Cyclohexanecarboxylic Acids; D014148:Tranexamic Acid