title: Effectiveness of tranexamic acid on blood loss in patients undergoing elective cesarean section: randomized clinical trial.
abstract: OBJECTIVE
  Cesarean section is associated with more blood loss than vaginal delivery. This could increase the risk of morbidity and mortality especially among anemic women. The objective of the trial is to assess the possible effect of tranexamic acid on blood loss during and after elective cesarean section.
  
  
  METHODS
  We conducted a randomized controlled trial at Women's Health Hospital, Assiut University, Assiut, Egypt. All pregnant women with singleton fetus planned to have elective cesarean section at ≥37 wks gestation were randomized to receive 1 g tranexamic acid slowly intravenously over 10 min before elective cesarean section group or not. Blood loss was measured during and for two hours after operation. Any side effects, complications, medications, changes in vital signs and duration of hospital stay were recorded. This study is registered, number ACTRN12612000313831.
  
  
  RESULTS
  Seven hundred and forty women were randomized (373 in study group and 367 in control group). Mean total blood loss was 241.6 (SE 6.77) ml in the tranexamic acid group versus 510 (SE 7.72) ml in the control group. The mean drop in hematocrit and hemoglobin levels were statistically significantly lower in the tranexamic acid group than in the control group. There were no statistically or clinically significant differences in other outcomes.
  
  
  CONCLUSIONS
  Pre-operative use of tranexamic acid is associated with reduced blood loss during and after elective cesarean section. This could be of benefit for anemic women or those who refuse blood transfusion.
authors.affiliation: Department of Obstetrics and Gynecology, Women's Health Centre , Assiut , Egypt and.
authors.forename: H
authors.initials: H
authors.lastname: Abdel-Aleem
authors.forename: T K
authors.initials: TK
authors.lastname: Alhusaini
authors.forename: M A
authors.initials: MA
authors.lastname: Abdel-Aleem
authors.forename: M
authors.initials: M
authors.lastname: Menoufy
authors.forename: A M
authors.initials: AM
authors.lastname: Gülmezoglu
mesh_terms: D000328:Adult; D000933:Antifibrinolytic Agents / Q000627:therapeutic use*; D016063:Blood Loss, Surgical / Q000517:prevention & control* / Q000706:statistics & numerical data; D002585:Cesarean Section / Q000009:adverse effects*; D017558:Elective Surgical Procedures / Q000009:adverse effects; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D019106:Postoperative Hemorrhage / Q000453:epidemiology / Q000517:prevention & control*; D006473:Postpartum Hemorrhage / Q000453:epidemiology / Q000517:prevention & control; D011247:Pregnancy; D014148:Tranexamic Acid / Q000627:therapeutic use*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000933:Antifibrinolytic Agents; D014148:Tranexamic Acid