The Role of Tranexamic Acid in Postpartum Hemorrhage in the High-Risk Obstetric Patient: A Retrospective Study

Postpartum hemorrhage (PPH) remains one of the leading causes of maternal death in the United States. There are several risk factors known to increase the risk of PPH and the use of tranexamic acid (TXA) has been widely researched in clinical situations with high bleeding risk. This retrospective observational study of the role of TXA and PPH in 418 high-risk obstetric patients was completed at a community hospital, and information on TXA administration, blood/colloid administration, and intraoperative and 24-hour estimated blood loss was evaluated for all patients who had a cesarean section within the study parameters. TXA doses ranged from .001 g to 2 g with a mean of 1.03 g (SD = 0.21). Using Games-Howell post-hoc testing, mean 24-hour EBL differed significantly among all groups except the uterotonics only group, which did not differ significantly from any other group. Twenty four-hour estimated blood loss was highest in those receiving both TXA and other uterotonic agents and lowest in those receiving neither.