Postpartum Hemorrhage Clinical Trial
Official title:
TRAnexamic Acid for Preventing Postpartum Hemorrhage Following a Cesarean Delivery :a Multicenter Randomised, Double Blind Placebo Controlled Trial (TRAAP2)
The aim is to assess the impact of tranexamic acid (TXA) for preventing postpartum hemorrhage (PPH) following a cesarean section (CS).
Regarding the prevention of PPH, recent randomized controlled trials (RCTs) of unclear
quality have suggested that TXA may reduce blood loss and maternal morbidity, while a
Cochrane Collaboration review has concluded, that "TXA (in addition to uterotonic
medications) decreases postpartum blood loss and prevents PPH and blood transfusions
following vaginal birth and CS in women at low risk of PPH based on studies of mixed quality.
Further investigations are needed on efficacy and safety of this regimen for preventing PPH.
Treatment, that is a 10-mL blinded vial of the study drug (either 1g TXA or placebo according
to the randomization sequence), will be administered intravenously to the participant women
during the third stage of labor of cesarean delivery.
The follow-up visit will take place in the postpartum ward of the maternity unit, on D2
postpartum. This stage will include a venous blood sample to measure plasma concentrations of
Hb and Ht, urea and creatinemia, prothrombin time (PT), active prothrombin time (aPTT),
aspartate and alanine transaminase, total bilirubin and fibrinogen, and the completion of a
self-questionnaire about satisfaction by the women, as well as the assessment of the adverse
events.
At 8 weeks postpartum, a self-questionnaire assessing psychological status and well-being
will be sent to the women. At 12 weeks postpartum, all participants will be contacted by
phone to assess the incidence of thrombotic and any other significant events.
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