School of Medicine and Health Sciences Poster Presentations

Title

Characteristics and outcomes of mothers receiving tranexamic acid during delivery

Document Type

Poster

Abstract Category

Women/Child Health

Keywords

obstetrics, PPH, post-partum hemorrhage, high-risk pregnancy, hemostasis

Publication Date

Spring 5-1-2019

Abstract

In October 2017, the American College of Obstetricians and Gynecologists (ACOG) released a practice bulletin endorsing the use of tranexamic acid (TXA) to treat postpartum hemorrhage (PPH). The purpose of this study was to describe characteristics and outcomes of women receiving TXA in the peripartum period. Patients were included as a multicenter retrospective cohort study between January 2015 and June 2018. All delivery types were included. Patients under the age of 18 or above the age of 50 were excluded. Patients were grouped based on whether or not TXA was administered and their demographics and outcomes were compared. Data trends in terms of time periods and geography was also analyzed. Of the 103,617 patients included, TXA was used in 133 patients at the time of delivery. Among our cohort those who received TXA compared to those who did not were more likely to have history of postpartum hemorrhage (26% vs 2%, p<0.0001), placenta previa (4.5% vs 0.3%, p<0.0001), anemia with hematocrit less than 32% (30% vs 16%, p<0.0001) and magnesium for neuroprotection (23% vs 5%, p<0.0001). There was no significant difference in rate of deep venous thrombosis or pulmonary embolism. Perinatal outcomes are also presented. TXA use was also evaluated by date and geographic sector. TXA was used at highest rates in the last quarter of 2018, with the East sector reporting higher rates compared to all other regions. Women who received TXA at delivery were more likely to have cesarean delivery, EBL>1000 cc, blood transfusion, and ICU admission, among other complications or comorbidities. Risk of venous thromboembolism was not increased with peripartum TXA use. More numbers are needed to assess if pre- and post-publication of the ACOG guidelines resulted in lower rates of hemorrhage complications.

Open Access

1

Comments

Presented at Research Days 2019.

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Characteristics and outcomes of mothers receiving tranexamic acid during delivery

In October 2017, the American College of Obstetricians and Gynecologists (ACOG) released a practice bulletin endorsing the use of tranexamic acid (TXA) to treat postpartum hemorrhage (PPH). The purpose of this study was to describe characteristics and outcomes of women receiving TXA in the peripartum period. Patients were included as a multicenter retrospective cohort study between January 2015 and June 2018. All delivery types were included. Patients under the age of 18 or above the age of 50 were excluded. Patients were grouped based on whether or not TXA was administered and their demographics and outcomes were compared. Data trends in terms of time periods and geography was also analyzed. Of the 103,617 patients included, TXA was used in 133 patients at the time of delivery. Among our cohort those who received TXA compared to those who did not were more likely to have history of postpartum hemorrhage (26% vs 2%, p<0.0001), placenta previa (4.5% vs 0.3%, p<0.0001), anemia with hematocrit less than 32% (30% vs 16%, p<0.0001) and magnesium for neuroprotection (23% vs 5%, p<0.0001). There was no significant difference in rate of deep venous thrombosis or pulmonary embolism. Perinatal outcomes are also presented. TXA use was also evaluated by date and geographic sector. TXA was used at highest rates in the last quarter of 2018, with the East sector reporting higher rates compared to all other regions. Women who received TXA at delivery were more likely to have cesarean delivery, EBL>1000 cc, blood transfusion, and ICU admission, among other complications or comorbidities. Risk of venous thromboembolism was not increased with peripartum TXA use. More numbers are needed to assess if pre- and post-publication of the ACOG guidelines resulted in lower rates of hemorrhage complications.