Effect of Tranexamic Acid Use on Estimated Blood Loss in Postpartum Hemorrhage

Yıl 2024, , 85 - 92, 26.09.2024

Mustafa Canbulut , Meltem Buz Baydilli , Ozge Yucel Celik

https://doi.org/10.46969/EZH.1489961

Öz

Objective: Postpartum hemorrhage is one of the most critical obstetric emergencies. This study aims to evaluate the effect of tranexamic acid on vital signs in cases of postpartum hemorrhage.
Material and Method: In this retrospective case-control study, the vital and laboratory values of the patients were recorded at the time of initial hospitalization, and at 2 and 6 hours after delivery. Mean arterial pressure (MAP) was calculated as Diastolic Blood Pressure + 1/3 (Systolic Blood Pressure- Diastolic Blood Pressure). The 2nd and 6th hour ΔHb was determined as the difference between the admission Hb and the Hb at 2 and 6 hours, respectively. Patients who received tranexamic acid treatment were compared to those who did not, based on these data.
Results: A total of 156 patients with postpartum hemorrhage who underwent cesarean section were included in our study. Of these patients, 83 received tranexamic acid treatment in addition to postpartum hemorrhage protocols and were included in the study group. The group that received the standard protocol without tranexamic acid treatment was included in the control group, consisting of 73 patients. The mean age of the patients in the study was 30.86±6.09 years, and the mean body mass index was 30.06±5.18 kg/m². Mean arterial pressure was higher in the study group compared to the control group (68.51±34.92 mm Hg vs. 56.20±40.33 mm Hg; p=0.001). The difference in hemogram values at 2 hours and 6 hours was significantly lower in the group that did not receive tranexamic acid compared to the study group (p=0.018, p=0.001).
Conclusion: It was observed that the addition of tranexamic acid to the treatment of postpartum hemorrhage significantly increased the mean arterial pressure of the patients and resulted in notable differences in hemogram changes.

Anahtar Kelimeler

Postpartum hemorrhage, tranexamic acid, vital signs, blood loss.

Traneksamik Asit Kullanımı Postpartum Kanamada Tahmini Kan Kaybına Olan Etkisi

Öz

Amaç: Postpartum kanama en önemli obstetrik acillerden birisidir. Traneksamik asidin postpartum kanamada vital bulgular üzerindeki etkisinin değerlendirilmesi planlanmıştır.
Gereç ve Yöntem: Bu retrospektif vaka kontrol çalışmada, hastaların vital ve laboratuvar değerleri için hastaneye ilk yatışında alınan değerler ile doğum sonrası 2. ve 6. saatlerindeki değerler alınmıştır. Ortalama arteryel basınç (MAP) = Diyastolik kan basıncı + 1/3 (sistolik kan basıncı – diyastolik kan basıncı) formülü ile hesaplanmıştır. 2. ve 6. saat ΔHb’leri hastanın giriş Hb ile 2. ve 6. saatlerindeki Hb’leri arasındaki fark olarak hesaplanmıştır. Traneksamik asit tedavisi alanlar ve almayanlar bu veriler üzerinden kıyaslanmıştır.
Bulgular: Çalışmamıza, postpartum kanaması olan ve sezaryan geçirmiş toplam 156 hasta dahil edilmiştir. Bu hastaların 83’üne postpartum kanama protokollerine ek olarak traneksamik asit tedavisi de verilmiştir ve çalışma grubuna dahil edilmiştir. Standard protokolün uygulanıp, traneksamik asit tedavisi almayan grup ise kontrol grubuna dahil edilmiştir ve bu grupta 73 hasta bulunmaktadır. Çalışmaya dahil edilen hastaların yaş ortalaması, 30.86±6.09 yıl iken, vücut kitle indexi ortalaması 30.06±5.18 kg/m2’dir. Çalışma grubunda ortalama arteriyel basıncın kontrol grubuna göre daha yüksek olduğu tesbit edilmiştir( 56.20±40.33mm Hg, 68.51±34.92 mm Hg; p=0.001) . Yapılan çalışmada ek tedavi olarak traneksamik asit almayan grupta 2 saat ve 6 saat hemogram değerlerindeki farklılık çalışma grubuna göre anlamlı olarak daha düşüktür (p=0.018, p=0.001).
Sonuç: Postpartum kanama tedavisine eklenen traneksamik asit ile hastaların özellikle ortalama arteriyel basınçlarda yükselme olduğu ve hemogram değişimlerinde farklılık olduğu gözlemlenmiştir.

Anahtar Kelimeler

Postpartum kanama, traneksamik asit, vital bulgular, kan kaybı.

Etik Beyan

Approval was obtained by the institutional review board from AnkaraEtlik Zübeyde Hanım Women's Health Training and Research Hospital on 24/04/2024 decision number 04/08.

Destekleyen Kurum

None

Teşekkür

None

Kaynakça

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