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Effect of Intravenous Tranexamic Acid in Reducing Blood Loss during and after elective caesarean section in a Third Level Health Institution: A Randomized Controlled Study

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Open Journal of Obstetrics and Gynecology 2023年第2期13卷 265-279页

作者： Darlington Omawumi Emmanuel Oranu Rosemary Ogu Ngozi Orazulike Job Otokwala Department of Obstetrics and Gynaecology University of Port Harcourt Teaching Hospital Port Harcourt Nigeria Department of Anaesthesiology University of Port Harcourt Teaching Hospital Port Harcourt Nigeria

Background: Blood loss during caesarean section (C/S) may lead to postpartum haemorrhage, and is one of the direct causes of maternal mortality and morbidity globally. Tranexamic acid is recommended in the treatment of postpartum haemorrhage (PPH) if oxytocin and other utertonics are ineffective in controlling PPH. In this centre it is not used prophylactically to reduce blood during caesarean section. Aim: To assess the effect of prophylactic intravenous tranexamic acid on blood loss during and after elective C/S at the University of Port Harcourt Teaching Hospital (UPTH). Methods: This was a prospective, single-blind, randomized, placebo-controlled interventional study conducted at the Obstetric theatre of UPTH from July 2020 to March 2021. Eligible women were randomized into two groups;seventy-two women received intravenous tranexamic acid while seventy-one women received a placebo. Socio-demographic data and the result of the study were collected through a proforma. Data collected was analyzed using Statistical Package for Social Sciences (SPSS) Version 22.0. The results were expressed in tables and charts as frequencies, percentages and mean. Chi-square test, Fisher’s exact, and T-test were used to determine the relationship between variables. P-value ≤ 0.05 was considered statistically significant. Results: The findings showed that tranexamic acid significantly reduced mean blood loss during and after C/S (p-value post-surgery was significantly lower in the tranexamic acid group (624.88 ± 200.76 ml) in comparison to the placebo group (864.24 ± 229.09 ml), p-value = 0.001. The mean post-C/S packed cell volume (PCV) was significantly higher among the tranexamic acid group (30.68% ± 2.80%) in comparison to the placebo group (28.07% ± 3.27%), t = 5.131, p-value = 0.0001. The maternal side effects were nausea and vomiting, 9 (12.5%) and 1 (1.4%) participants respectively. Conclusion: Tranexamic acid significantly reduced blood loss during and after elective C/S. Ma

关键词： Tranexemic Acid Blood Loss elective caesarean section Port Harcourt

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Hepatitis B in pregnancy

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World Journal of Gastroenterology 2012年第34期18卷 4677-4683页

作者： Guglielmo Borgia Maria Aurora Carleo Giovanni Battista Gaeta Ivan Gentile Department of Public Medicine and Social Security Section of Infectious DiseasesUniversity of Naples "Federico Ⅱ"80131 NaplesItaly Department of Internal Medicine Section of Infectious DiseasesSecond University of Naples80131 NaplesItaly

Chronic hepatitis B virus (HBV) infection affects about 350 million individuals worldwide. Management of HBV infection in pregnancy is difficult because of several peculiar and somewhat controversial aspects. The aim of the present review is to provide a tool that may help physicians to correctly manage HBV infection in pregnancy. This review focuses on (1) the effect of pregnancy on HBV infection and of HBV infection on pregnancy; (2) the potential viral transmission from mother to newborn despite at-birth prophylaxis with immunoglobulin and vaccine; (3) possible prevention of mother-to-child transmission through antiviral drugs, the type of antiviral drug to use considering their efficacy and potential teratogenic effect, and the timing of their administration and discontinuation; and (4) the evidence for the use of elective caesarean section vs vaginal delivery and the possibility of breastfeeding.

关键词： Hepatitis B virus Pregnancy Therapy Te-nofovir Lamivudine Telbivudine Entecavir Breastfeed-ing elective caesarean section

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