The Effect of Oral and Intravenous Tranexamic Acid on Reducing the Incidence of Postpartum Hemorrhage after Cesarean Section: A Randomized Controlled Clinical Trial

Document Type : Original Article

Authors

1 Assistant Professor, Department of Obstetrics and Gynecology, Abnormal Uterine Bleeding Research Center, Semnan University of Medical Sciences, Semnan, Iran.

2 Gynecology and Obstetrics Specialist, Laparoscopy Fellowship, Arash Women Hospital, Tehran University of Medical Sciences, Tehran, Iran.

3 General Physician, Faculty of Medicine, Semnan University of Medical Sciences, Semnan, Iran.

4 Assistant Professor, Department of Epidemiology, Social Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran.

5 Assistant Professor, Department of Pharmacology, Cancer Research Center, School of Pharmacy, Semnan University of Medical Sciences, Semnan, Iran.

10.22038/ijogi.2025.86105.6360

Abstract

Introduction: Given the existing discrepancies in the effectiveness of oral and intravenous administration of tranexamic acid, the present study was conducted with aim to compare the impact of the two forms of oral and intravenous tranexamic acid on reducing the incidence of postpartum hemorrhage following cesarean section.
Methods: This randomized controlled clinical trial was conducted during 2023–2024 on 100 pregnant women scheduled for elective cesarean section at Amir al-Momenin Hospital, Semnan. Participants were randomly assigned to two groups of intravenous tranexamic acid group (1 g before surgery) and oral tranexamic acid group (2 g one hour before surgery) (n=50 in each group). Intraoperative blood loss, serum hemoglobin and hematocrit levels, and drug-related side effects were compared between the two groups. Data were analyzed using SPSS software (version 16). P<0.05 was considered statistically significant.
Results: After the surgery, the oral tranexamic acid group compared to the intravenous group showed significantly higher heart rate (p=0.021), intraoperative blood loss (p<0.001), and the incidence of side effects (p=0.016), along with significantly lower serum hemoglobin (p=0.013) and hematocrit levels (p=0.003).
Conclusion: Intravenous tranexamic acid compared to the oral form demonstrated superior effectiveness in reducing postpartum hemorrhage after cesarean section and was associated with fewer side effects.

Keywords

Main Subjects

References

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The Iranian Journal of Obstetrics, Gynecology and Infertility
Volume 28, Issue 5
July 2025
Pages 19-28

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