Clinical observation of blood loss reduced by tranexamic acid during and after caesarian section: a multi-center, randomized trial. [Clinical study on the efficacy of tranexamic acid in reducing postpartum blood lose: a randomized, comparative, multicenter trial].
To explore the efficacy and safety of tranexamic acid at caesarian section (CS).
                Prospective, randomized, case-controlled clinical trial.
                One hundred and eighty primiparas were randomized into two groups. The study group, 91 women, received tranexamic acid immediately before CS whereas the control group, 89 women did not.
                Blood was collected during two periods. The first period was from placental delivery to the end of CS and the second was from the end of CS to 2 h postpartum. The quantity of blood was measured and compared between the two groups. Complete blood count, urinalysis, liver and renal function, prothrombin time and activity, were tested in the two groups.
                Tranexamic acid significantly reduced the quantity of blood from the end of CS to 2 h postpartum: 42.75 +/- 40.45 ml in the study group versus 73.98 +/- 77.09 ml in the control group (P=0.001). It also significantly reduced the quantity of total blood from placental delivery to 2 h postpartum: 351.57 +/- 148.20 ml in the study group, 439.36 +/- 191.48 ml in the control group (P=0.002). No complications or side effects were reported in either group.
                Tranexamic acid statistically reduces the extent of bleeding from placental delivery to 2 h postpartum and its use was not associated with any side effects or complications. Thus, tranexamic acid can be used safely and effectively to reduce bleeding resulting from CS. To study the efficacy and safety of Transamin (tranexamic acid) in reducing postpartum blood loss.
                Four hundred primipara with term singleton pregnancy, vertex presentation, spontaneous delivery were enrolled. Ten U Oxytocin was injected intravenously immediately after the delivery of fetal shoulders in the second stage of labor. Then all the puerperants were randomly assigned to 4 groups. Group I (n = 94): Transamin 1.0 g was injected i.v.; Group lI (n = 92): Transamin 0.5 g i.v.; Group III (n = 92): aminomethylbenzoic acid 0.5 g i.v. was given; Group IV (n = 87): no treatment. Vaginal bleeding was precisely collected, and examined immediately after the expulsion of placenta and from placenta expulsion till 2 hours after delivery. The amount of blood loss was measured by both methods of weight and volume.
                There were no significant differences of blood loss immediately after the expulsion of placenta among the 4 groups (P > 0.05). For the average blood loss at 2 hour postpartum, it was 129.7 ml, 133.9 ml, 168.5 ml and 178.2 ml for group I, II, II and IV respectively, while the total blood loss for the 4 groups was 243.3 ml, 242.9 ml, 308.1 ml, and 314.8 ml respectively. The average blood loss of group I and II was significantly less than group III and IV (P < 0.01), however, there was no significant difference between group I and group II (P > 0.05). The occurrences of postpartum hemorrhage (blood lose > or = 400 ml) were 6.4%, 13.3%, 20.7% and 25.3% for group I, II, III and IV respectively. There was no major adverse effects appeared.
                Transamin is efficient and safe in reducing the postpartum blood loss. 1.0 g of Transamin has the best efficacy, and 0.5 g of Transamin followed.