COMPARISON OF THERAPEUTIC EFFECTIVENESS OF OXYTOCIN VERSUS OXYTOCIN PLUS TRANEXAMIC ACID IN THE PREVENTION OF POST-PARTUM HEMORRHAGE
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Abstract
Objective: To compare mean blood loss with Oxytocin plus Tranexamic acid versus Oxytocin alone in the prevention of postpartum hemorrhage.
Methodology: This randomized controlled trial was conducted in Department of Obstretrics & Gynaecology, Lady Reading Hospital, Peshawar on 400 women, distributed into two equal groups. Group A received 10 IU of I/V Oxytocin along with 1g of I/V tranexamic acid during the third stage of labor immediately after birth and Group B received 10 IU of I/V Oxytocin only immediately after birth. The incidence of postpartum hemorrhage was based on weighing dry and soaked pads using a digital weight machine and blood loss was measured. The drug was considered effective in terms of mean reduction of blood loss after 2 hours.
Results: Our study shows that in group A (Oxytocin plus Tranexamic acid), the mean age was 30±4.29 years whereas in group B (Oxytocin alone), the mean age was 31±4.71 years. In group A, mean blood loss was 30 ml± 6.02 whereas in group B, mean blood loss was 40 ml ± 7.88. The mean blood loss volume shows a significant difference in between the two groups with a p-value of 0.0001.
Conclusion: The study concludes a significant difference in mean blood loss volume after getting treatment for post-partum hemorrhage in both the treatment groups i.e Oxytocin plus Tranexamic (Gorup A) and Oxytocin alone (Group B). Furthermore, mean blood loss volume was much less in Group A as compared to Group B, illustrating effective treatment modality in Group A.
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References
Pantoja T, Abalos E, Chapman E, Vera C, Serrano V. Oxytocin for prevent¬ing postpartum haemorrhage (PPH) in non-facility birth settings. Cochrane Database Syst Rev. 2016;4:CD011491. https://doi.org/10.1002/14651858. CD011491.pub2.
De Castro Parreira M, Gomes N. Pre¬venting postpartum haemorrhage: active management of the third stage of labour. J Clin Nurs. 2013;22(23- 24):3372-87. https://doi.org/10.1111/ jocn.12361.
Ali TS, Ather F. Prevalence of perceived heavy postpartum hemorrhage and its associated factors among married mothers in squatter settlements of Ka¬rachi. Khyber Med Uni J. 2013; 5(1):3- 8.
Kumar N, Pathak SS, Singh NK, Rudra S. Effectiveness of simulation tech¬nique in teaching-learning process for prevention of postpartum hemor¬rhage in obstetrics and gynecology. Int J Reprod Contracept Obstet Gy¬necol. 2016; 5(8): 2756-61. http:// dx.doi.org/10.18203/2320-1770.ijr¬cog20162661.
Faraoni D, Carlier C, Samama C, Levy J. Efficacy and safety of tranexamic acid administration for the prevention and/or the treatment of post-partum haemorrhage: A systematic review with meta-analysis. Annales Français¬esd’ Anesthésie et de Réanimation. 2014;33(11):563-71. https://doi. org/10.1016/j.annfar.2014.07.748.
Alam A, Choi S. Prophylactic use of tranexamic acid for postpartum bleeding outcomes: a systematic re-view and meta-analysis of random¬ized controlled trials. Transfus Med Rev. 2015;29(4):231-41. https://doi. org/10.1016/j.tmrv.2015.07.002
Novikova, N., Hofmeyr, G. and Cluver, C. Tranexamic acid for preventing post¬partum haemorrhage. Cochrane Da¬tabase Syst Rev. 2015;(6):CD007872. https://doi.org/10.1002/14651858. CD007872.pub3
Shakur H, Elbourne D, Gülmezoglu M, Alfirevic Z, Ronsmans C, Allen E, et al. The WOMAN Trial (World Maternal An¬tifibrinolytic Trial): tranexamic acid for the treatment of postpartum haemor¬rhage: an international randomised, double blind placebo controlled tri¬al. Trials. 2010;11:40. https://doi. org/10.1186/1745-6215-11-40.
Sentilhes L, Lasocki S, Ducloy-Bouthors A, Deruelle P, Dreyfus M, Perroti F, et al. Tranexamic acid for the prevention and treatment of postpartum haemorrhage. Br J Anaesth. 2016;116(5):641-8. https://doi.org/10.1093/bja/aeu448.
Sekhavat L, Tabatabaii A, Dalili M, Farajkhoda T. Efficacy of tranexamic acid in reducing blood loss after ce¬sarean section. Int Society Perinatal Obstet. 2009;22(1):72-5. https://doi. org/10.1080/14767050802353580.
Barbieri RL, Sentilhes L. Advances in preventing postpartum hemorrhage. N Engl J Med. 2018: 1-8.
Xiong X, Buekens P, Alexander S, Demi-anczuk N, Wollast E. Anemia during pregnancy and birth out-come: A meta-analysis. Am J Perina¬tol. 2000;17(3):137-46. https://doi. org/10.1055/s-2000-9508
Xia Y, Griffiths, Xue BB, Sheng Q. Tranexamic acid for postpartum hemorrhage prevention in vag¬inal delivery. A meta-analysis. Medicine. 2020:99(3):e18792. h t t p s : / / d o i . o r g / 1 0 . 1 0 9 7 / md.0000000000018792.
Ducloy-Bouthors AS, Jude B, Duhamel A, Broisin F, Huissoud C, Keita-Meyer H et al. High-dose tranexamic acid reduc¬es blood loss in postpartum haemor¬rhage. Critical Care. 2011;15(2):R117. https://doi.org/10.1186/cc10143.
Hawker L, Weeks A. Postpartum haem¬orrhage (PPH) rates in randomized trials of PPH prophylactic interventions and the effect of underlying participant PPH risk: a meta-analysis. BMC Pregnancy Childbirth. 2020;20(1):1-2. https://doi. org/10.1186/s12884-020-2719-3.
Atoyebi W, Mundy N, Croxton T, Little¬wood TJ, Murphy MF. Is it necessary to administer anti-D to prevent RhD immunization after the transfusion of RhD-positive platelet concentrates? Br J Haematol. 2000;111(3):980-3.
Bonnar J. Massive obstetric haemor¬rhage. Baillieres Best Pract Res Clin Ob¬stet Gynaecol. 2000;14(1):1-18. https:// doi.org/10.1053/beog.1999.0060.
Lingam K, Hood V, Carty MJ. Angio¬graphic embolisation in the manage¬ment of pelvic haemorrhage. BJOG. 2000;107(9):1176-8. https://doi. org/10.1111/j.1471-0528.2000. tb11122.x.