Prophylactic Administration of Tranexamic Acid Reduces Blood Products’ Transfusion and Intensive Care Admission in Women Undergoing High-Risk Cesarean Sections
Abstract
1. Introduction
2. Materials and Methods
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Characteristic | Tranexamic Acid Group (N = 500) | No Tranexamic Acid Group (N = 500) | p Value |
---|---|---|---|
Age (years) | 32.30 ± 5.73 | 32.88 ± 5.47 | 0.0987 |
Height (cm) | 161.3 ± 5.7 | 161.7 ± 5.8 | 0.2157 |
Weight (Kg) | 81.05 ± 15.28 | 80.65 ± 13.89 | 0.6587 |
Gravity—median (range) | 4 (1–25) | 4 (1–16) | 0.583 |
Parity—median (range) | 3 (0–12) | 3 (0–12) | 0.5865 |
Previous cesarean delivery—no. (%) | 339 (67.8%) | 338 (67.6%) | 0.9442 |
Number of cesarean delivery—median (range) | 3 (1–8) | 3 (1–8) | 0.8572 |
Gestational diabetes—no. (%) | 54 (10.8%) | 56 (11.2%) | 0.8414 |
HTN chronic—no. (%) | 13 (2.6%) | 13 (2.6%) | 1.000 |
Hypothyroidism—no. (%) | 21 (4.2%) | 18 (3.6%) | 0.6241 |
Kidney disease—no. (%) | - (0.0%) | - (0.0%) | - |
History of PPD—no. (%) | 8 (1.6%) | 9 (1.8%) | 0.8103 |
Anticoagulation Therapy | 32 (6.4%) | 23 (4.6%) | 0.2113 |
Pregnancy week | 36.75 ± 2.55 | 36.56 ± 2.88 | 0.2697 |
Singletons | 406 (81.2%) | 415 (83%) | 0.4593 |
Twins | 88 (17.6%) | 81 (16.2%) | 0.5552 |
Triplets | 6 (1.2%) | 3 (0.6%) | 0.3173 |
Quadruplets | 0 (0%) | 1 (0.2%) | 0.3173 |
Placenta previa | 26 (5.2%) | 19 (3.8%) | 0.2846 |
Placenta accreta | 6 (1.2%) | 3 (0.6%) | 0.3173 |
Outcome | Tranexamic Acid Group (N = 500) | No Tranexamic Acid Group (N = 500) | p Value |
---|---|---|---|
Delta hemoglobin (gr/dL) | 0.85 ± 1.02 | 1.42 ± 1.01 | <0.0001 |
Hemoglobin decrease ≥ 2 gr/dL—no (%) | 57 (11.4%) | 126 (25.2%) | <0.0001 |
Hemoglobin drop >10%—no (%) | 177(35.4%) | 297 (59.4%) | <0.0001 |
Estimated blood loss% (mL) | 705.2 ± 178.06 | 766.82 ± 172.48.26 | <0.0001 |
Estimated blood loss > 1000 mL—no (%) | 42 (8.4%) | 53 (10.6%) | 0.2808 |
Emergent hysterectomy—no (%) | 3 (0.6%) | 3 (0.6%) | 1 |
Packed red blood cell transfusion during surgery—no (%) | 7 (1.4%) | 15 (3%) | 0.1313 |
Packed red blood cell transfusion during surgery above 3 units | 1 (0.2%) | 3 (0.6%) | 0.3173 |
FFP transfusion during surgery—no (%) | 5 (1%) | 9 (1.8%) | 0.4194 |
Cryoprecipitate transfusion during surgery—no (%) | 5 (1%) | 6 (1.2%) | 1 |
Platelet transfusion during surgery—no (%) | 2 (0.4%) | 6 (1.2%) | 0.2869 |
Packed red blood cell transfusion 48 h—no (%) | 21 (4.2%) | 40 (8%) | 0.0174 |
FFP transfusion 48 h—no (%) | 5 (1%) | 6 (1.2%) | 1 |
Cryoprecipitate transfusion 48 h—no (%) | 4 (0.8%) | 4(0.8%) | 1 |
Platelet cell transfusion 48 h—no (%) | 3 (0.6%) | 4 (0.8%) | 1 |
ICU admission—no (%) | 2 (0.4%) | 9 (1.8%) | 0.034 |
Hospital stay (days) | 4.52 ± 1.48 | 5.12 ± 2.4 | <0.0001 |
Hospital stay > 5 days—no (%) | 59 (11.8%) | 109 (21.8%) | <0.0001 |
Complication | Tranexamic Acid Group | No Tranexamic Acid Group | p Value |
---|---|---|---|
Acute renal failure no (%) | 1 (0.2%) | 3 (0.6%) | 0.6164 |
Delta creatinine (mg/dL) | −0.003 ± 0.11 | −0.006 ± 0.02 | 0.9276 |
Thromboembolic event no (%) | 1 (0.2%) [DVT − 1] | 2 (0.4%) [DVT − 1, PE − 1] | 1 |
Seizure no. (%) | 3 (0.6%) | 8 (1.6%) | 0.2252 |
Outcome | Tranexamic Acid Group N = 592 | No Tranexamic Acid Group N = 581 | p Value |
---|---|---|---|
APGAR 1 min—median (range) | 9 (0–9) | 9 (0–9) | 0.1724 |
APGAR 1 min < 5—no (%) | 23 (3.89%) | 27 (4.64%) | 0.5157 |
APGAR 5 min—median (range) | 10 (0–10) | 10 (0–10) | 0.7422 |
APGAR 5 min < 5—no (%) | 11 (1.86%) | 15 (2.58%) | 0.4009 |
PH | 7.29 ± 0.082 | 7.28 ± 0.093 | 0.3314 |
PH < 7.2—no (%) | 35 (5.91%) | 50 (8.6%) | 0.07508 |
Multivariable Logistic Regression Model for the Association between Prophylactic Tranexamic Acid and Hemoglobin Drop >10% | |||
Odds Ratio | 95% CI | p Value | |
Age | 0.99414 | 0.9681; 1.0207 | 0.6629 |
BMI | 1.00449 | 0.9784; 1.0312 | 0.7376 |
Parity | 1.06255 | 0.9936; 1.1370 | 0.0771 |
Number of CS | 0.88044 | 0.7917; 0.9781 | 0.0180 |
Pregnancy week | 1.0033 | 0.9558; 1.0531 | 0.8931 |
TxA administration | 0.3807 | 0.2931; 0.4932 | <0.0001 |
Anemia (Hb < 11.0) | 0.5626 | 0.4290; 0.7361 | <0.0001 |
Multivariable Logistic Regression Model for the Association between Prophylactic Tranexamic Acid and EBL > 1000 mL | |||
Odds Ratio | 95% CI | p Value | |
Age | 0.9848 | 0.9414; 1.0296 | 0.5037 |
BMI | 0.9940 | 0.9498; 1.0379 | 0.7919 |
Parity | 1.1157 | 1.0063; 1.2323 | 0.0332 |
Number of CS | 1.017393 | 0.8648; 1.1963 | 0.8345 |
Pregnancy week | 0.9748 | 0.9063; 1.0549 | 0.5091 |
TxA administration | 0.7690 | 0.4986; 1.1792 | 0.2303 |
Anemia (Hb < 11.0) | 1.1929 | 0.7698; 1.8365 | 0.4250 |
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Binyamin, Y.; Frenkel, A.; Gruzman, I.; Lerman, S.; Bichovsky, Y.; Zlotnik, A.; Stav, M.Y.; Erez, O.; Orbach-Zinger, S. Prophylactic Administration of Tranexamic Acid Reduces Blood Products’ Transfusion and Intensive Care Admission in Women Undergoing High-Risk Cesarean Sections. J. Clin. Med. 2023, 12, 5253. https://doi.org/10.3390/jcm12165253
Binyamin Y, Frenkel A, Gruzman I, Lerman S, Bichovsky Y, Zlotnik A, Stav MY, Erez O, Orbach-Zinger S. Prophylactic Administration of Tranexamic Acid Reduces Blood Products’ Transfusion and Intensive Care Admission in Women Undergoing High-Risk Cesarean Sections. Journal of Clinical Medicine. 2023; 12(16):5253. https://doi.org/10.3390/jcm12165253
Chicago/Turabian StyleBinyamin, Yair, Amit Frenkel, Igor Gruzman, Sofia Lerman, Yoav Bichovsky, Alexander Zlotnik, Michael Y. Stav, Offer Erez, and Sharon Orbach-Zinger. 2023. "Prophylactic Administration of Tranexamic Acid Reduces Blood Products’ Transfusion and Intensive Care Admission in Women Undergoing High-Risk Cesarean Sections" Journal of Clinical Medicine 12, no. 16: 5253. https://doi.org/10.3390/jcm12165253
APA StyleBinyamin, Y., Frenkel, A., Gruzman, I., Lerman, S., Bichovsky, Y., Zlotnik, A., Stav, M. Y., Erez, O., & Orbach-Zinger, S. (2023). Prophylactic Administration of Tranexamic Acid Reduces Blood Products’ Transfusion and Intensive Care Admission in Women Undergoing High-Risk Cesarean Sections. Journal of Clinical Medicine, 12(16), 5253. https://doi.org/10.3390/jcm12165253