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Reducing Blood Loss During Abdominal Hysterectomy with Intravenous Versus Topical Tranexamic Acid: A Double-Blind Randomized Controlled Trial

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Abstract

Objectives

To assess the effect of intravenous versus topical tranexamic acid in reducing intraoperative and postoperative blood loss in women with abdominal hysterectomy.

Materials and Methods

The study was a randomized double-blind placebo-controlled trial, carried out in a tertiary university hospital in Egypt, from November 2015 to October 2017. A total of 129 women undergoing abdominal hysterectomy for benign etiology were randomly assigned to three groups: Group I [43 patients received 110 ml normal saline IV just before skin in scion], Group II [43 patients received 1 g tranexamic acid in 100 ml saline IV just before skin in scion], and Group III [43 patients received 2 g topical tranexamic acid applied intra-abdominal after hysterectomy]. The primary outcome was intraoperative, postoperative, and all blood loss estimation.

Results

Both Group II (IV tranexamic acid) and Group III (topical tranexamic acid application) showed great reduction in intraoperative and postoperative blood loss (blood in the intra-abdominal drain) compared with Group I (placebo group), (P = 0.0001, 0.0001, 0.0001, 0.0001), so the overall estimated blood loss in groups II and III showed highly reduction compared with Group I (P = 0.0001, 0.0001).

Conclusion

Intravenous and topical tranexamic acid application is a safe and reliable method to help decrease blood loss during and after abdominal hysterectomy.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Faculty of Medicine, Aswan University, Aswan, Egypt

    Hany F. Sallam & Nahla W. Shady

Authors
  1. Hany F. Sallam
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  2. Nahla W. Shady
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Corresponding author

Correspondence to Hany F. Sallam.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

Approval from Ob/Gyn Department at Aswan university hospital was obtained (2-10-2015).

Informed Consent

An informed verbal and written consent of the study subjects to participate in the study was obtained with assurance of confidentiality and anonymity of the data. Subjects participated voluntarily with full right to with draw from the study.

Additional information

Hany F. Sallam is Lecturer of Obstetrics and Gynecology, Faculty of Medicine, Aswan University, Egypt; Nahla W. Shady is an Associated Professor of Obstetrics and Gynecology, Faculty of Medicine, Aswan University, Egypt.

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Sallam, H.F., Shady, N.W. Reducing Blood Loss During Abdominal Hysterectomy with Intravenous Versus Topical Tranexamic Acid: A Double-Blind Randomized Controlled Trial. J Obstet Gynecol India 69, 173–179 (2019). https://doi.org/10.1007/s13224-018-1149-x

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  • DOI: https://doi.org/10.1007/s13224-018-1149-x

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