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首页> 外文期刊>Journal of Clinical and Diagnostic Research >Effectiveness of Tranexamic Acid for Reducing Postpartum Blood Loss in the First Two Hours after Vaginal Delivery: A Randomised Controlled Trial
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Effectiveness of Tranexamic Acid for Reducing Postpartum Blood Loss in the First Two Hours after Vaginal Delivery: A Randomised Controlled Trial

机译：氨甲环酸减少阴道分娩后头两个小时产后失血的有效性：一项随机对照试验

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Postpartum Haemorrhage (PPH) is the leading direct cause of maternal death worldwide, especially in developing countries. Fibrinolysis is an important process in bleeding during the third stage of labour. Tranexamic acid (TA) is used to reduce the fibrinolysis process which might reduce the blood loss after delivery.Aim: To study the effectiveness of intravenous TA for reducing postpartum blood loss in the first two hours after vaginal delivery.Materials and Methods: A prospective double blinded Randomised Controlled Trial (RCT) was performed. The participants were randomly allocated to receive either an intravenous infusion of TA (n=75) or a placebo (n=75) after delivery of the anterior shoulder. A prophylactic intramuscular injection of 10 units of oxytocin was used in both groups. Blood loss was directly measured using a collective bag combined with a gravimetric of gauzes and diapers during the first two hours postpartum. The means of blood loss of both groups were compared. The prevalence of PPH (>500 ml) and severe PPH (>1,000 ml) in both groups were analysed. Statistical analysis were performed using Stata13 (Stata Corp, College Station, TX). A p-value below 0.05 was considered statistically significant.Results: Seventy two participants in the TA group and 69 participants in the placebo group completed this study. Mean blood loss in the first two hours for the TA group was not significantly different from the placebo group (226.59±114.66 ml versus 234.05±142.41 ml, p=0.73). Adjusted mean difference was 4.61 ml (95% CI: -48.25 to 39.02). The frequency of PPH was one case in the TA group and three cases in the placebo group (one case was severe PPH). Only one woman had a mild side effect (nausea) and no episode of thrombosis occurred in the women who received TA.Conclusion: In normal delivery, the addition of TA did not reduce the amount of postpartum blood loss in the first two hours compared with prophylaxis oxytocin only.
机译：产后出血（PPH）是全世界孕产妇死亡的主要直接原因，尤其是在发展中国家。纤维蛋白溶解是第三产程出血的重要过程。氨甲环酸（TA）用于减少纤维蛋白溶解过程，这可能会减少分娩后的失血。目的：研究静脉内TA在减少阴道分娩后的前两个小时内减少产后失血的有效性。材料和方法：进行了一项前瞻性双盲随机对照试验（RCT）。参与者被随机分配在前肩分娩后接受TA（n = 75）或安慰剂（n = 75）的静脉输注。两组均使用预防性肌肉注射10单位的催产素。在产后前两个小时，使用集液袋和重量计的纱布和尿布直接测量失血量。比较两组的失血量。分析两组中PPH（> 500 ml）和严重PPH（> 1,000 ml）的患病率。使用Stata13（Stata Corp，College Station，TX）进行统计分析。 p值低于0.05被认为具有统计学意义。结果：TA组的72名参与者和安慰剂组的69名参与者完成了本研究。 TA组头两个小时的平均失血量与安慰剂组无显着差异（226.59±114.66 ml对234.05±142.41 ml，p = 0.73）。调整后的平均差异为4.61 ml（95％CI：-48.25至39.02）。 TA组中PPH的发生率为1例，安慰剂组中为3例（其中1例为严重PPH）。只有一名女性有轻度的副作用（恶心），接受过TA的女性中没有血栓形成的发生。结论：在正常分娩中，添加TA并没有减少前两次的产后失血量小时与仅预防催产素相比。

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