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Efficacy of tranexamic acid in decreasing blood loss during cesarean section

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Despite significant progress in obstetric care, the problem of bleeding during labor remains unfinished. Annually in the world 125,000 women die from obstetric hemorrhage.


We performed a randomized, double-blind study in 37 patients who underwent cesarean section. Patients were divided into two groups: the first group (n = 19) received preoperative (30 minutes before operation) tranexamic acid 10 mg/kg; the second group (n = 18) received preoperative placebo. The condition of hemostasis was monitored by haemoviscoelastography.


All patients included in the study before the surgery had moderate hypercoagulation and normal fibrinolysis: increasing of the intensity of clot formation (ICF) to 11.4% compared to normal rates; the intensity of the retraction and clot lysis (IRCL) was 16.45 ± 1.40 in both groups. At the start of the operation in patients (group 1) - ICF decreased 9.7% (P < 0.05), and IRCL decreased 27.6% (P < 0.05) compared with preoperatively. In group 2, ICF decreased 8.8% (P < 0.05), and IRCL increased 11.4% (P < 0.05) compared with preoperatively. At the end of the operation, the condition of hemostasis in both groups came almost to the same value - moderate hypocoagulation, depressed fibrinolysis. In both groups there were no thrombotic complications. Intraoperative blood loss in the first group was 300 ± 40.5 and in the second was 500 ± 60.6.


Using tranexamic acid before surgery significantly reduces intraoperative blood loss by 40%, without thrombotic complications.

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Correspondence to O Tarabrin.

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Tarabrin, O., Kaminskiy, V., Galich, S. et al. Efficacy of tranexamic acid in decreasing blood loss during cesarean section. Crit Care 16, P439 (2012).

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  • Public Health
  • Placebo
  • Blood Loss
  • Normal Rate
  • Cesarean Section