• About Us
    • Contact Us
    • Login
    • ObGFirst
  • Alerts
  • OB
  • 2T US Atlas
  • The Genome
  • GYN
    • GYN
    • Sexual Health
  • Primary Care
  • Your Practice
  • GrandRounds
  • My Bookshelf
  • COVID-19
About Us Contact Us Login ObGFirst
  • Alerts
  • OB
  • 2T US Atlas
  • The Genome
  • GYN
    • GYN
    • Sexual Health
  • Primary Care
  • Your Practice
  • GrandRounds
  • My Bookshelf
  • COVID-19
Grand Rounds

Does Tranexamic Acid Reduce Blood Loss in Cesarean Delivered Multiple Pregnancies?

image_pdfFavoriteLoadingFavorite

BACKGROUND AND PURPOSE:

  • Sentilhes et al. (AJOG, 2022) compared the effect of TXA vs placebo to prevent blood loss after cesarean delivery among women with multiple pregnancies

METHODS:

  • Secondary analysis of multicenter, randomized, placebo-controlled, double-blind trial with 2 parallel groups
    • TRAnexamic Acid for Preventing Postpartum Hemorrhage Following a Cesarean Delivery randomized (TRAAP2) trial
  • Population
    • Multiple pregnancy
    • Cesarean delivery before or during labor at ≥34 weeks of gestation
  • Intervention
    • TXA: 1 g IV, plus prophylactic uterotonics
    • Placebo, plus prophylactic uterotonics
  • Primary outcome
    • Calculated estimated blood loss of >1000 mL or a red blood cell transfusion by 2 days post-delivery
  • Secondary outcomes
    • Clinical and laboratory blood loss measurements

RESULTS:

  • TXA: 147 individuals | Placebo: 152 individuals
    • All multiples were twins
  • There was no difference in the incidence of the primary outcome between the intervention groups
    • TXA: 42.2%
    • Placebo: 44.1%
    • aRR 0.97 (95% CI, 0.68 to 1.38); P=0.86
  • There were also no significant between-group differences for any hemorrhage-related clinical outcome (P>0.05 for all comparisons)
    • Gravimetrically estimated blood loss | Provider-assessed clinically significant hemorrhage | Additional uterotonics | Postpartum blood transfusion | Arterial embolization | Emergency surgery

CONCLUSION:

  • The use of prophylactic TXA did not reduce the risk for blood loss or hemorrhage-related outcomes in individuals with multiple pregnancy at time of cesarean
  • The authors state

Further randomized controlled trial (RCT) studies are required to determine whether prophylactic TXA plus a prophylactic uterotonic agent would be associated with a lower incidence of postpartum hemorrhage after cesarean delivery than the uterotonic agent alone in high-risk populations, such as women with placenta previa or those with preeclampsia 

Learn More – Primary Sources:

Tranexamic acid for the prevention of blood loss after cesarean among women with twins: a secondary analysis of the TRAnexamic Acid for Preventing Postpartum Hemorrhage Following a Cesarean Delivery randomized clinical trial

Want to stay on top of key guidelines and research papers?

ObGFirst® – Try It Free! »

image_pdfFavoriteLoadingFavorite
< Previous
All Grand Rounds Posts
Next >

Related ObG Topics:

Cost-Effectiveness of Routine TXA Treatment for PPH in the US
Results From the Landmark Trial on Tranexamic Acid for Postpartum Hemorrhage
What is the Optimal Dosage of TXA for Postpartum Hemorrhage Prevention?
Cochrane Review: TXA for Postpartum Hemorrhage – Safe and Effective?

Sections

  • Alerts
  • OB
  • GYN
    • GYN
    • Sexual Health
  • 2T US Atlas
  • The Genome
  • Primary Care
  • Your Practice
  • Grand Rounds
  • My Bookshelf
  • COVID-19

Are you an
ObG Insider?

Get specially curated clinical summaries delivered to your inbox every week for free

  • Site Map/
  • © ObG Project/
  • Terms and Conditions/
  • Privacy/
  • Contact Us/
© ObG Project
SSL Certificate


  • Already an ObGFirst Member?
    Welcome back

    Log In

    Want to sign up?
    Get guideline notifications
    CME Included

    Sign Up

Sign In

Lost your password?

Sign Up for ObGFirst and Stay Ahead

  • - Professional guideline notifications
  • - Daily summary of a clinically relevant
    research paper
  • - Includes 1 hour of CME every month

ObGFirst Free Trial

Already a Member of ObGFirst®?

Please log in to ObGFirst to access the 2T US Atlas

Password Trouble?

Not an ObGFirst® Member Yet?

  • - Access 2T US Atlas
  • - Guideline notifications
  • - Daily research paper summaries
  • - And lots more!
ObGFirst Free Trial

Media - Internet

Computer System Requirements

OBG Project CME requires a modern web browser (Internet Explorer 10+, Mozilla Firefox, Apple Safari, Google Chrome, Microsoft Edge). Certain educational activities may require additional software to view multimedia, presentation, or printable versions of their content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Flash, Apple QuickTime, Adobe Acrobat, Microsoft PowerPoint, Windows Media Player, or Real Networks Real One Player.

Disclosure of Unlabeled Use

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Disclaimer

Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information
presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.

Jointly provided by

NOT ENOUGH CME HOURS

It appears you don't have enough CME Hours to take this Post-Test. Feel free to buy additional CME hours or upgrade your current CME subscription plan

Subscribe

JOIN OBGFIRST AND GET CME/CE CREDITS

One of the benefits of an ObGFirst subscription is the ability to earn CME/CE credits from the ObG entries you read. Tap the button to learn more about ObGFirst

Learn More
Leaving ObG Website

You are now leaving the ObG website and on your way to PRIORITY at UCSF, an independent website. Therefore, we are not responsible for the content or availability of this site