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2018 ; 16
(4
): 329-337
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Safety and efficacy of tranexamic acid for prevention of obstetric haemorrhage:
an updated systematic review and meta-analysis
#MMPMID29757132
Franchini M
; Mengoli C
; Cruciani M
; Bergamini V
; Presti F
; Marano G
; Pupella S
; Vaglio S
; Masiello F
; Veropalumbo E
; Piccinini V
; Pati I
; Liumbruno GM
Blood Transfus
2018[Jul]; 16
(4
): 329-337
PMID29757132
show ga
BACKGROUND: A number of clinical systematic review and meta-analysis have been
published on the use of tranexamic in the obstetric setting. The aim of this
meta-analysis was to evaluate the safety and effectiveness of tranexamic acid in
reducing blood loss when given prior to caesarean delivery. MATERIALS AND
METHODS: We searched the Cochrane Wounds Specialized Register, Cochrane Central,
MEDLINE (through PUBMED), Embase, and SCOPUS electronic databases. We also
searched clinical trials registries for ongoing and unpublished studies, and
checked reference lists to identify additional studies. We used no restrictions
with respect to language and date of publication. Two review authors
independently performed study selection, "Risk of bias" assessment, and data
extraction. Initial disagreements were resolved by discussion, or by including a
third review author when necessary. RESULTS: We found 18 randomised controlled
trials (RCTs) that met our inclusion criteria. Overall, 1,764 women receiving
intravenous tranexamic acid for prevention of bleeding following caesarean
sections and 1,793 controls receiving placebo were enrolled in the 18 RCTs
evaluated. The use of tranexamic acid compared to controls (placebo or no
intervention) reduces post-partum haemorrhage >400 mL (risk ratio [RR] 0.40, 95%
confidence interval [CI] 0.24-0.65; 5 trials with a total of 786 participants),
severe post-partum haemorrhage >1,000 mL (RR 0.32, 95% CI: 0.12-0.84; 5 trials
with a total of 1,850 participants), and need for red blood cell transfusion (RR
0.30, 95% CI: 0.18-0.49; 10 trials with a total of 1,873 participants). No
particular safety concerns on the use of this antifibrinolytic agent emerged from
the analysis of the 18 RCTs included. DISCUSSION: Overall, the results of this
meta-analysis support the evidence of a beneficial effect of tranexamic acid in
reducing blood loss and need for blood transfusion in pregnant women undergoing
caesarean section.
|*Cesarean Section
[MESH]
|Blood Loss, Surgical/*prevention & control
[MESH]