Effectiveness of Tranexamic Acid in Reducing Blood Loss during Placenta Accreta Spectrum, A Randomized Controlled Trial | ||
| The Egyptian Journal of Hospital Medicine | ||
| Volume 100, Issue 1, July 2025, Pages 4259-4265 PDF (462.96 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/ejhm.2025.419635.1834 | ||
| Authors | ||
| Maraey Menoufy Khalil Ali* 1; Aya Sayed Abdelrady2; Hossam Ramadan Abdulwahab Ismail3; Sherif Mohammed Abdel Mageed Badran4 | ||
| 1Aswan Egypt | ||
| 2Faculty of medicine, Aswan University | ||
| 3Faculty of medicine, Aswan University. | ||
| 4Faculty of medicine, Assiut University. | ||
| Abstract | ||
| Background: Placenta accreta spectrum (PAS) represents a critical obstetric complication described as by the risk of massive hemorrhage. Tranexamic acid (TXA), an antifibrinolytic compound, has been demonstrated to effectively minimize blood loss in various surgical contexts, nevertheless its effectiveness in the management of PAS has not been thoroughly investigated. Objective: This study aimed to assess the efficacy of prophylactic TXA in minimizing intraoperative blood loss and limiting transfusion requirements in cases with PAS undergoing Cesarean delivery. Methods: A randomized controlled trial (RCT) was executed at Aswan University Hospital (October 2024–August 2025) involving 94 women with PAS scheduled for Cesarean delivery. Participants were allocated randomly to had either 1 g IV TXA (n=47) or saline (n=47) before skin incision. Intraoperative blood loss served as the primary endpoint, with operative time, transfusion requirement, and hospitalization duration defined as secondary endpoints. Results: The TXA group (G) had significantly reduced mean hemorrhage (398.23 ± 133.25 mL vs. 533.81 ± 101.79 mL; P value = 0.0003), fewer PRBC infused (1.02 ± 0.87 vs. 2.17 ± 1.11 units; P value = 0.0002), and shorter hospital stays (4.89 ± 0.89 vs. 6.30 ± 1.08 days; P value = 0.0008). Operative time was reduced in the TXA G (44.79 ± 6.8 vs. 49.5 ± 6.5 minutes; P value = 0.002). No thromboembolic events or maternal deaths occurred. Conclusion: Prophylactic TXA significantly reduces hemorrhage, requirement for blood transfusion, and hospital stay in PAS surgeries without increasing adverse events. | ||
| Keywords | ||
| Placenta accreta spectrum; Tranexamic acid; Postpartum hemorrhage; Cesarean section | ||
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