Blood loss | Hemoglobin decline | PPH | Transfusion
TXA administration was associated with significantly lower
Total blood loss
Mean difference (MD) -189.44 ml (95% CI, -218.63 to -160.25)
MD 8.22% (95% CI, 5.54 to 10.90)
Risk of blood loss >1000 ml
Odds ratio (OR) 0.37 (95% CI, 0.22 to 0.60)
OR 0.41 (95% CI, 0.26 to 0.65)
Need of additional uterotonics
OR 0.36 (95% CI, 0.25 to 0.52)
Subgroup analysis indicated a greater effect of TXA on total blood loss reduction in low-middle income countries
Outcomes were still stable when women who were at low bleeding risk were evaluated separately
The quality of evidence was
Moderate for total blood loss and hemoglobin percentage change
Low for the other outcomes
In this updated meta-analysis, prophylactic TXA was effective at reducing PPH in women undergoing cesarean
Results similar to previous Cochrane review: Significant decrease in PPH (moderate quality evidence)
The authors state
…the present meta-analysis confirmed and extended the results of previous ones in the field, by including a significantly larger sample size despite the use of strict eligibility criteria, enabling the exploration of heterogeneity and a more accurate appraisal of evidence quality
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