{"id":6274,"date":"2022-06-18T12:20:00","date_gmt":"2022-06-18T10:20:00","guid":{"rendered":"https:\/\/fhu-premimpact.org\/?post_type=publication&#038;p=6274"},"modified":"2023-01-03T12:25:11","modified_gmt":"2023-01-03T11:25:11","slug":"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-r","status":"publish","type":"publication","link":"https:\/\/fhu-premimpact.org\/en\/publications\/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-r\/","title":{"rendered":"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"},"content":{"rendered":"\n<h2 class=\"wp-block-heading\">Abstract<\/h2>\n\n\n\n<p><strong>Background:<\/strong> Although prophylactic tranexamic acid administration after cesarean delivery resulted in a lower incidence of calculated estimated blood loss of &gt;1000 mL or red cell transfusion by day 2, its failure to reduce the incidence of hemorrhage-related secondary clinical outcomes (TRAnexamic Acid for Preventing Postpartum Hemorrhage Following a Cesarean Delivery trial) makes its use questionable. The magnitude of its effect may differ in women at higher risk of blood loss, including those with multiple pregnancies.<\/p>\n\n\n\n<p><strong>Objective:<\/strong> This study aimed to compare the effect of tranexamic acid vs placebo to prevent blood loss after cesarean delivery among women with multiple pregnancies.<\/p>\n\n\n\n<p><strong>Study design:<\/strong> This was a secondary analysis of the TRAnexamic Acid for Preventing Postpartum Hemorrhage Following a Cesarean Delivery trial data, a double-blind, randomized controlled trial from March 2018 to January 2020 in 27 French maternity hospitals, that included 319 women with multiple pregnancies. Women with a cesarean delivery before or during labor at \u226534 weeks of gestation were randomized to receive intravenously 1 g of tranexamic acid (n=160) or placebo (n=159), both with prophylactic uterotonics. The primary outcome was a calculated estimated blood loss of &gt;1000 mL or a red blood cell transfusion by 2 days after delivery. The secondary outcomes included clinical and laboratory blood loss measurements.<\/p>\n\n\n\n<p><strong>Results:<\/strong> Of the 4551 women randomized in this trial, 319 had a multiple pregnancy and cesarean delivery, and 298 (93.4%) had primary outcome data available. This outcome occurred in 62 of 147 women (42.2%) in the tranexamic acid group and 67 of 152 (44.1%) receiving placebo (adjusted risk ratio, 0.97; 95% confidence interval, 0.68-1.38; P=.86). No significant between-group differences occurred for any hemorrhage-related clinical outcomes: gravimetrically estimated blood loss, provider-assessed clinically significant hemorrhage, additional uterotonics, postpartum blood transfusion, arterial embolization, and emergency surgery (P&gt;.05 for all comparisons).<\/p>\n\n\n\n<p><strong>Conclusion:<\/strong> Among women with a multiple pregnancy and cesarean delivery, prophylactic tranexamic acid did not reduce the incidence of any blood loss-related outcomes.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Am J Obstet Gynecol. 2022 Dec;227(6):889.e1-889.e17<\/p>\n","protected":false},"featured_media":0,"template":"","class_list":["post-6274","publication","type-publication","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.2 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>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 - 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