Clinical Study to Assess the Equivalence of Tranexamic Acid vs Oxytocin in Reducing the PPH (TRANOXY2015)

Postpartum Hemorrhage Clinical Trial

— TRANOXY2015  

Official title:

Clinical Study,Longitudinal,Controlled, Randomized, Open-label, Phase III,to Assess the Equivalence of Tranexamic Acid vs Oxytocin in Reducing the Post Partum Hemorrhage (PHH) in Patients at the End of Pregnancy (37-42 w) at Low Risk of PPH

Clinical Trial Details — Status: Withdrawn

Administrative data

• NCT number: NCT02503319
• Other study ID #: AzUSL1 di Massa e Carrara
• Status: Withdrawn
• Phase: Phase 3
• Start date: January 2016
• Est. completion date: January 2016

Study information

• Verified date: January 2016
• Source: Azienda U.S.L. 1 di Massa e Carrara
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The purpose of this study was to evaluate that the tranexamic acid (TXA)Intravenous and oral, is equivalent oxytocin (OXY),intramuscularly, in reducing the blood loss in post partum period (mL) in patients at the end of pregnancy ( 37-42 w ) at low risk of post partum hemorrhage (PPH). The PPH means a blood loss equal to or greater than 500 ml after a vaginal delivery ( the bleeding is defined severe if it exceeds 1000 mL). PPH is called "primary" when blood loss arose within 24 hours after birth. This is a open-trial randomized, longitudinal, controlled that including 486 subjects .

Description:

This trial includes three arms of treatment : - arm A (IMP1Test): TXA 500mg/ 2 vials (1 gr) oral within 5 minutes from the delivery (third stage af labor) - arm B (IMP2Test): TXA 500 mg/ 2 vials (1 gr) slow intravenous infusion 1ml/min within 5 minutes from the delivery(third stage af labor) - arm C (control): OXY 5 IU/ml/ 2 vials (10 International Unit) intramuscularly within 5 minutes from the delivery (third stage af labor) The clamping of the umbilical cord will be executed immediately after birth The randomization 1:1:1 (block design), generated by the computer. Primary outcomes: assessment of total blood loss expressed in mL - immediately after delivery - two hours after delivery The measurement of the overall blood loss at delivery (ml) will be performed by the graduated bag, immediately after birth. The measurement two hours after delivery will be performed by weighing of the adsorbent material [ N.ml = N. gr indicated by the balance - dry weight of the sanitary napkin]. The overall loss in blood measured (ml) two hours of delivery will then be performed by adding the two collections.

Recruitment information / eligibility

• Status: Withdrawn
• Enrollment: 0
• Est. completion date: January 2016
• Est. primary completion date: January 2016
• Accepts healthy volunteers: No
• Gender: Female
• Age group: 18 Years to 50 Years

Eligibility

Inclusion Criteria:

• Subjects at the end of pregnancy ( 37-42 w ) at low risk of PPH Mean by low-risk of PPH subjects without any of the following risk factors : hypertension/preeclampsia, placental abruption during pregnancy , placenta previa , tocolysis two hours before delivery, multiple pregnancy , previous PPH, obesity ( BMI > 35 ), anemia (Hb < 7 g/dL), elective caesarean section , induction of labor, retention of placental material , polyhydramnios , fever during labor, use of high doses of heparin low molecular weight.
• Subjects full capacity and the willingness to give written informed consent .

Exclusion Criteria:

• Subjects with preterm pregnancy (<37 weeks ) or with prolonged pregnancy ( > 42 weeks )
• Subjects at the end of pregnancy ( 37 weeks - 42 weeks ) with the following risk factors for PPH (Tab1)
• multiple pregnancy
• history of thromboembolic disease or high incidence of thromboembolic events in family history ( patients at high risk of thrombophilia )
• Patients with Long - QT syndrome or who are taking drugs that cause QT prolongation
• Intrauterine fetal Death
• epilepsy
• autoimmune disease Tab1 medical history :
• Placental abruption during pregnancy
• placenta previa
• Hypertension / preeclampsia
• previous PPH
• polyhydramnios
• Obesity ( BMI > 35 )
• Anemia ( < 7 g / dL )

Detectable in labor:

• Elective caesarean section
• Tocolysis two hours before delivery
• Induction of labor
• Retention of placental material
• Fever during labor
• Use of low molecular weight heparin

Related Conditions & MeSH terms

• Hemorrhage
• Postpartum Hemorrhage

Intervention

Drug:
• Tranexamic Acid
2 vials ( =1 gram) of Tranexamic Acid oral administered within 5 minutes from the delivery (third stage after labor) 2 vials (=1 gram ) of Tranexamic Acid administered slow intravenous infusion within 5 minutes from the delivery (third stage after labor)
• Tranexamic Acid
2 vials ( =1 gram) of Tranexamic Acid slow intravenous infusion administered within 5 minutes from the delivery (third stage after labor)
• Oxytocin
2 vials (=10 IU/International Unit) of oxytocin administered intramuscularly within 5 minutes from the delivery (third stage after labor)

Locations

Country	Name	City	State
n/a

Sponsors (2)

Lead Sponsor	Collaborator
Azienda U.S.L. 1 di Massa e Carrara	Dr.Antonio Franco Ragusa

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	assessment of total blood loss expressed in mL	global blood loss > 500 mL	immediately after delivery
Primary	assessment of total blood loss expressed in mL	global blood loss > 500 mL	two hours after delivery
Secondary	assessment of the number of hemodynamic changes	hypotension (number of women with Arterial Pressure < 100/60 mm/Hg )	immediately after delivery
Secondary	assessment of the number of hemodynamic changes	hypotension (number of women with Arterial Pressure < 100/60 mm/Hg )	two hours after delivery
Secondary	assessment of the number of hemodynamic changes	increased heart rate (number of women with Heart Rate > 60 bpm )	immediately after delivery
Secondary	assessment of the number of hemodynamic changes	increased heart rate (number of women with Heart Rate > 60 bpm )	two hours after delivery
Secondary	assessment of the need of using additional uterotonic	administration additional drug for the treatment of PPH	immediately after delivery
Secondary	assessment of the need of using additional uterotonic	administration additional drug for the treatment of PPH	two hours after delivery
Secondary	assessment the need for surgical manoeuvres for the bleeding control	need of intrauterine balloon or uterine compression sutures for surgical treatment of the PPH or hysterectomy	immediately after delivery
Secondary	assessment the need for surgical manoeuvres for the bleeding control	need of intrauterine balloon or uterine compression sutures for surgical treatment of the PPH or hysterectomy	two hours after delivery
Secondary	assessment the need for the blood transfusions	Hb <7 g/dL	two days after delivery