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Use of tranexamic acid in decreasing blood loss during and after delivery among women in Africa: a systematic review and meta-analysis

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Abstract

Background

Africa is a developing continent with a high maternal mortality rate. It is beneficial to implement interventions that alleviate the problem. As a result, this systematic review and meta-analysis was carried out to summarize evidence that will assist concerned bodies in proposing strategies to reduce maternal mortality due to post-partum hemorrhage.

Methods

This systematic review and meta-analysis includes randomized control trials (RCT) studies searched from various databases (PubMed, Web of Sciences, SCOPUS, African Journal Online, Clinical trials, and African indexes Medics). Data synthesis and statistical analysis were conducted using a combination of review manager 5.3 and STATA Version 14 software. The effect measure utilized was the standardized mean difference for estimated mean blood loss and mean hemoglobin level.

Results

This systematic review and meta-analysis includes a total of 3308 women. The pooled standardized mean difference showed that tranexamic acid statistical significantly reduced the estimated amount of blood loss after vaginal delivery (standardized mean difference with 95% CI − 0.93 [− 1.45, − 0.41]) and during and after cesarean delivery (standardized mean difference with 95% CI − 1.93 [− 2.40, − 1.47]).

Conclusion

Tranexamic acid has been found to be a good choice for reducing blood loss during and after delivery in Africa regardless of the mode of delivery. Tranexamic acid had no effect on hemoglobin levels before and after delivery. To reduce maternal mortality due to post-partum hemorrhage, it is critical to implement and strengthen interventions aimed at increasing tranexamic acid uptake in Africa.

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Data availability

The data that support the review findings of this study are available upon submitting a reasonable request to the corresponding author.

Abbreviations

C/D:

Cesarean delivery

MeSHs:

Medical subject headings

PPH:

Postpartum hemorrhage

PRISMA:

Preferred reporting items for systematic reviews and meta-analysis

SMD:

Standardized mean difference

TXA:

Tranexamic acid

WHO:

World Health Organization

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Acknowledgements

We would like to thank the College of Health and Medical Sciences, Haramaya University for the support to perform these meta-analyses.

Funding

The authors have not disclosed any funding.

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Authors and Affiliations

Authors

Contributions

AE, TG, AD, TT, and BB conceived and designed the review. AE*, TG, HB, MA, DT, and GT carried out the draft of the manuscript, and AE* is the PI of the review. AE*, TG, AD, and KS developed the search strings. AE, TG, KS, DT, MD, BE, SH, TB, ML, EY, GA and BB screened and selected studies. AE, HB, MA, GT, and AD extracted the data and evaluated the quality of the studies. AE, TT, AD, DT, MA, YD, and AA carried out analysis and interpretation. AE, TG, HB, DT, BB, AD, GT, MA, AM, FA, AA, AG. AA and TT rigorously reviewed the manuscript. All authors read and approved the final version of the manuscript.

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Correspondence to Addis Eyeberu.

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Eyeberu, A., Getachew, T., Amare, G. et al. Use of tranexamic acid in decreasing blood loss during and after delivery among women in Africa: a systematic review and meta-analysis. Arch Gynecol Obstet 308, 709–725 (2023). https://doi.org/10.1007/s00404-022-06845-1

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