This is a prospective, double-blinded, randomized placebo-controlled trial. The study will be approved by the DUHS institutional review board (IRB) and the trial will be registered at clinical trial registry. After receiving the trial information from the obstetricians during prenatal visits or from the anaesthetists during the systematic anaesthesia visit, or both the prospective women will be invited to participate in the trial. The intervention consists of administration of 1gm of tranexemic acid (TXA) or 10-mls of placebo (normal saline) intravenously, according to the randomization groups slowly over 30-60 sec, within 3 mins of the delivery of baby, after the routine prophylactic uterotonic administration and cord clamping. Administration of the prophylactic uterotonic agent (and TXA or placebo) may be followed by a two-hour oxytocin infusion, in accordance with the hospital policy. All women will be followed up at 48 hours after caeserian delivery. A venous blood sample will be obtained on day-two (D2) after delivery for outcome assessment. Adverse events will be assessed until hospital discharge and by telephone interview at 8 weeks after delivery.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
QUADRUPLE
Enrollment
572
The intervention consists of administration of 1gm of Tranexamic acid (TXA) intravenously or 10-mls of placebo (normal saline) intravenously, slowly over 30-60 sec, within 3 mins of the delivery of baby.
DowUHS
Karachi, Sindh, Pakistan
Occurrence of postpartum haemorrhage (PPH)
Time frame: up to 2 days
Obstetrics quality of recovery (ObsQoR) score
Time frame: at 2 days
Measurement of postpartum blood loss
Time frame: at 2 days
Operative time
Time frame: up to 3 hours
Length of hospital stay
Time frame: up to 4 days
Frequency of emergency surgery for postpartum haemorrhage
Time frame: up to 12 hours
Rate of ICU transfer
Time frame: up to 1 day
Rate of Maternal death
Time frame: up to 3 months
Adverse events related to tranexamic acid
Time frame: up to 3 months
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