Tranexamic Acid in Pregnancies With Vaginal Bleeding

Tranexamic Acid for Antepartum Bleeding of Unknown Origin in the Second and Third Trimester: Nonrandomized Controlled Trials

Tranexamic acid has been proposed and used for prevention and management of antepartum and postpartum hemorrhage.

Bleeding during pregnancy is associated with a three- to fourfold increase in perinatal mortality. Hemorrhage in pregnancy is characterized by activation of the fibrinolytic system. Tranexamic acid is a potent pharmaceutical agent that suppresses fibrinolysis, and thus can be used for managing hemorrhage in pregnancy. The FDA's pregnancy category for tranexamic acid is category B. Tranexamic acid has been used to decrease blood loss and treatment of intra partum blood loss in cesarean section also it has been used for prevention and management of postpartum hemorrhage after vaginal bleeding, regardless of whether the bleeding is due to genital tract trauma or other causes.

Tranexamic acid was prescribed for pregnant women with vaginal bleeding of unknown etiology in second and third trimester (13-34 weeks) gestation

expectant management, including admission to hospital, ultrasound examination at least twice a week, regular blood coagulation tests, fetal wellbeing , frequent ultrasound performing for placenta location ,betamethasone administration for whom delivery was suspected

Trenaxa , Manufacturer Macleods Pharmaceuticals, TRANSAMIN , NIKOLAKOPOULOS A.E. GALATSIOU AVENUE, Athens

One gram( 2 ampules ) of tranexamic acid was received by the participant intravenously twice daily for 48 hours followed by 500 mg tranexamic acid tablet three times daily for 5 days . follow up of the patient was done by recurrence of the bleeding latter on during pregnancy . the course of treatment was repeated again .

Following up the pregnant woman clinically to approve cessation of vaginal bleeding after Tranexamic acid use using yes/No format

total number of newborn delivered showing no signs of life (movement, appearance, cardiac pulsation) plus deaths of newborn in first week of life

Neonatal Apgar(Appearance, Pulse, Grimace, Activity, and Respiration) score Apgar scores includes 10 sores , 2 for each . The Apgar score was classified as severely depressed <0-3>, moderately depressed<4-6> and excellent condition<7-10>

Apgar scores includes 10 sores , 2 for each . The Apgar score was classified as severely depressed 0-3, moderately depressed 4-6 and excellent condition 7-10

Inclusion Criteria: pregnant woman having vaginal bleeding Second and third trimester of unknown etiology No placenta previa, abruptio placentae, local cervical or vaginal causes for bleeding Primigraivid, multiparous and grand multiparous woman Accept to participate in the trial Exclusion Criteria: Hypersensitivity to tranexamic acid Women with acquired defective color vision History of venous thromboembolism Refused to participate