Case Report
Tranexamic Acid for the Prevention of Primary Postpartum Hemorrhage in a High Risk Multigravida
Omar Viswanath, Howard Goldman, and Sushmitha Santhosh
Correspondence Address :
Omar Viswanath,
Department of Anesthesiology,
Mount Sinai Medical
Center, Miami Beach,
Florida, USA,
Email: viswanoy@gmail.com
Received on: January 03, 2017, Accepted on: January 23, 2017, Published on: January 30, 2017
Citation: Omar Viswanath, Howard Goldman, Sushmitha Santhosh (2017). Tranexamic Acid for the Prevention of Primary Postpartum Hemorrhage in a High Risk Multigravida
Copyright: 2017 Omar Viswanath, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Abstract
We present a 31 year old chronically anemic G4P3 obstetric patient with a significant history of primary postpartum hemorrhage (PPH) requiring transfusion of blood after prior elective cesarean delivery. Given her history and risk factors for PPH along with her high risk for bleeding secondary to her anemia, the anesthesiologist administered an anti-fibrinolytic medication, tranexamic acid (TXA) after the umbilical cord was clamped, in an attempt to prevent PPH without exposing the neonate to the drug. The patient did not experience PPH nor required blood transfusion. This case report focuses on three important aspects of TXA administration: the timing of administration, the unknown potential effects of TXA on the neonate, and the utilization of the drug on high risk patients. Our case shows that TXA may have helped our high risk patient without exposing the neonate. Although there is promise in the use of TXA for prevention and treatment of PPH, large, high quality randomized controlled trials are necessary before its widespread use can be recommended.
Keywords: Perioperative complications, High risk obstetric partituents, Primary postpartum hemorrhage, Tranexamic acid, Cesarean delivery, Chronic anemia, Multiple pregnancies, Anesthetic issues and peri-operative care, Coagulopathy, Preoperative evaluation and anesthesia risk