Background: Postpartum haemorrhage (PPH) is an important cause of early maternal
death which needs to be controlled.
Objective: This study was designed to compare the effect of intravenous tranexamic acid (TXA)
and prostaglandin analogue on reducing PPH resulted from uterine atony in women undergoing C
section or vaginal delivery.
Method: A randomized, triple-blind, placebo-controlled study was conducted on 248 pregnant
women with PPH due to uterine atony who were randomly assigned into two groups of TXA as the
intervention group (n=124) and prostaglandin analogue as the control group (n=124). The intervention
group received 4 g TXA for an hour and then 1 g over 6 hours infusion intravenously and the
control group received prostaglandin analogue.
Results: Postoperative bleeding did not significantly differ between the two groups (68.2±6.1 ml
and 69.1±175.73 ml, respectively, P =0.6). Moreover, hemoglobin declines were 1±0.4 g/dl and
1.2±0.5 g/dL in TXA and prostaglandin group respectively, indicating that the difference was not
statistically significant (P =0.7).
Conclusion: The results of the present study showed that administrating intravenous TXA had
comparable effects with prostaglandin analogue on reducing PPH in women with uterine atony and
in those undergoing C section or vaginal delivery. Therefore, TXA can be used instead of prostaglandin
in managing such patients.