Topical Tranexamic Acid Plus Bilateral Uterine Artery Ligation During Cesarean Delivery
Status:
Unknown status
Trial end date:
2021-01-01
Target enrollment:
Participant gender:
Summary
Placenta previa (PP) is an obstetric condition that is closely linked with massive obstetric
hemorrhage with a varied incidence about once in every 200 live births. It is considered one
of the causes of the increased need for blood transfusion and cesarean hysterectomy. PPH due
to PP typically starts during cesarean section (CS) in the placental bed, at the lower
uterine segment mostly after placental separation. Proceeding for cesarean hysterectomy can
be the only effective line of management in spite of the associated high morbidity rate.
Various conservative measures have been developed to avoid hysterectomy and preserve
fertility in patients with PP. Bilateral Uterine artery ligation (BUAL) is one of the
reported surgical procedures carried out in these cases as it is easy and quick. It can be
used alone or with adjunctive measures with a fair success rate. The aim is to reduce the
blood supply to the uterus and to prevent postpartum hemorrhage.
Tranexamic acid is a lysine analog which acts as an antifibrinolytic via competitive
inhibition of the binding of plasmin and plasminogen to fibrin. The rationale for its use in
the reduction of blood loss depending on the implication of the coagulation and fibrinolysis
processes implicated in the control of PPH. However, concerns about possible thromboembolic
events with parenteral administration of TA have stimulated increasing interest in its
topical use.