The Effect of Intravenous Tranexamic Acid on Hemoglobin and Hematocrit Levels after Vaginal Delivery: A Randomized Controlled Trial

Document Type : Original Article


1 Ph.D. of Reproductive Health, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.

2 Ph.D. of Reproductive Health, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran

3 Assistant Professor, Department of Obstetrics and Gynecology, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.

4 M.Sc. Student of Midwifery, Student Research Committee, Tabriz University of Medical Sciences, Aras International Branch, Tabriz, Iran.


Introduction: Postpartum hemorrhage may cause anemia or deplete iron stores in women. Prevention of postpartum hemorrhage can play an important role in promoting women's health. Some studies indicate the efficacy of tranexamic acid in reducing bleeding after vaginal delivery. This study was done to investigate the effect of intravenous tranexamic acid on hemoglobin and hematocrit level after vaginal delivery in women who were low risk in postpartum hemorrhage.
Methods: This triple blind randomized controlled trial was carried out on 120 pregnant women referred to Alzahra hospital, Tabriz, Iran, 2012. Patients were divided into two groups of 60 cases using block randomization. Both groups got 10 units oxytocin after placenta delivery. After delivery of the anterior shoulder, subjects in intervention group received 1gr intravenous tranexamic acid and control group received 1gr placebo in 200 ml normal saline over 10 minutes. Hemoglobin and hematocrit levels were measured 1-12 hours before and 12-24 hours after delivery. Data were analyzed using SPSS software version 13, chi-square, Fisher, chi-square for trend, independent t-test and paired t-test. P value less than 0.05 was considered significant.
Results: Before intervention, the mean of hemoglobin and hematocrit was respectively 12.9±0.9 g/dl and 38.3±2.3% in intervention group and 13.0±0.9 g/dl and 38.8±2.0% in control group (p>0.05). After intervention, mean of hemoglobin loss was 1.4±0.9 g/dl in intervention group and 1.7±1.0 g/dl in control group (p=0.11). The mean of hematocrit loss was 3.7±2.3% in intervention group and 4.8±3.0% in control group (p=0.03).
Conclusion: Administration of tranexamic acid had significant effect in reducing the mean of hematocrit loss. Thus, use of this drug may help promote maternal heath in the postpartum period.