Comparison of the Mean Blood Loss during Cesarean Section with 15mg/Kg Versus 10 Mg/Kg Intravenous Tranexamic Acid in Anemic Women Undergoing Lower Segment Cesarean Section

Abstract

Objective: To compare the mean blood loss during cesarean section with 15mg/kg versus 10 mg/kg intravenous tranexamic acid (TXA) in anemic women undergoing lower segment cesarean section.

Methodology: A randomized controlled trial conducted at the Department of Gynecology at Recep Tayyip Erdogan Hospital, Muzaffargarh, from May 2023 to October 2024. Anemic women undergoing emergency lower segment cesarean section with singleton pregnancy, aged 18 to 40 years and gestational age >37 weeks were enrolled. Patients were randomly assigned into two groups using the lottery method: Group I received 15 mg/kg and Group II received 10 mg/kg of intravenous TXA administered 20 minutes before surgery. Blood loss during LSCS was measured using the gravimetric method by weighing surgical materials before and after the procedure, while hemoglobin levels were monitored preoperatively and 24 hours postoperatively. All collected data were entered and analyzed using SPSS version 25.0.

Results: Overall mean age of the participants was 26.85 +4.97 years and mean gestational age was 38.60 + 1.16 weeks. Group I (15 mg/kg) had a slightly higher postoperative HB level (9.09 g/dL vs. 8.78 g/dL, p = 0.074) compared to Group I. Estimated blood loss was also lower in Group I versus Group II (491.36 mL vs. 521.89 mL, p = 0.079), suggesting a higher dose showed a trend toward better outcomes, while the differences were not statistically significant (p=>0.05).

Conclusion: The higher dose TXA showed a tendency toward lower estimated blood loss and better postoperative hemoglobin levels compared to the lower dose, suggesting that a higher intravenous tranexamic acid dose may offer better hemostatic control. However, there was lack of statistical significance across the doses.