Efficacy of Tranexamic Acid in Reducing Myomectomy-Associated Blood Loss among Patients with Uterine Myomas at Federal Teaching Hospital Abakaliki: A Randomized Control Trial.

التفاصيل البيبلوغرافية
العنوان:	Efficacy of Tranexamic Acid in Reducing Myomectomy-Associated Blood Loss among Patients with Uterine Myomas at Federal Teaching Hospital Abakaliki: A Randomized Control Trial.
المؤلفون:	Olaleye AA; Department of Obstetrics and Gynaecology, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Nigeria., Adebayo JA; Department of Obstetrics and Gynaecology, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Nigeria., Eze JN; Department of Obstetrics and Gynaecology, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Nigeria., Ajah LO; Department of Obstetrics and Gynaecology, University of Nigeria Teaching Hospital, Enugu, Nigeria., Anikwe CC; Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria., Egede JO; Department of Obstetrics and Gynaecology, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Nigeria., Ebere CI; Department of Obstetrics and Gynaecology, Alex Ekwueme Federal University Teaching Hospital, Abakaliki, Nigeria.
المصدر:	International journal of reproductive medicine [Int J Reprod Med] 2024 Jan 18; Vol. 2024, pp. 2794052. Date of Electronic Publication: 2024 Jan 18 (Print Publication: 2024).
نوع المنشور:	Journal Article
اللغة:	English
بيانات الدورية:	Publisher: Hindawi Pub. Co Country of Publication: Egypt NLM ID: 101633172 Publication Model: eCollection Cited Medium: Print ISSN: 2356-7104 (Print) Linking ISSN: 23145757 NLM ISO Abbreviation: Int J Reprod Med Subsets: PubMed not MEDLINE
أسماء مطبوعة:	Original Publication: Cairo : Hindawi Pub. Co.
مستخلص:	Background: Myomectomy can be associated with life-threatening conditions such as bleeding. Excessive bleeding usually necessitates blood transfusion. Interventions to reduce bleeding during myomectomy will help reduce the need for blood transfusion with its associated complications. Tranexamic acid has been used to reduce bleeding in other surgical procedures, and its usage during myomectomy merits evaluation. Objective: To assess the efficacy of tranexamic acid in reducing myomectomy-associated blood loss. Materials and Methods: This is a prospective double-blinded randomized trial conducted on women who had abdominal myomectomy. Patients were randomized into two groups. The study group received perioperative intravenous tranexamic acid (TXA) while the control group received a placebo. Intraoperative blood loss was calculated by measuring the volume in the suction apparatus and weighing the surgical swabs. In addition, blood collected postoperatively from the wound drains and drapes were measured. Haemoglobin concentrations were determined preoperatively and on second postoperative day for all cases. Any adverse effect was noted in both groups. The data was processed using Epi Info software (7.2.1, CDC, Atlanta, Georgia). The relationships between categorical data were analyzed using X ² and Student's t -test to determine relationships between continuous variables, with a P value of 0.05 considered statistically significant, and correlation coefficients were calculated using Pearson's formula, and probability of 0.05 was set for statistical significance. Results: Symptomatic uterine myomas constituted 17.3% of all gynaecological admissions and 21.3% of gynaecological operations at Federal Teaching Hospital Abakaliki. The mean intraoperative blood loss among patients that had perioperative tranexamic acid infusion was 413.6 ± 165.6 ml, while that of patients with placebo infusion was 713.6 ± 236.3 ml. Perioperative tranexamic acid infusion therefore reduced mean intraoperative blood loss by 300 ml, and this was statistically significant (SMD = -0.212, 95% CI: -403.932 to -196.067, P < 0.0001). Perioperative tranexamic acid reduced mean total blood loss by a value of 532.3 ml, and this is statistically significant (SMD = 30.622, 95% CI: 393.308 to 670.624, P < 0.0001). Tranexamic acid also improved postoperative haemoglobin concentration by 1.8 g/dl compared with placebo, and this is statistically significant (SMD = -0.122, 95% CI: 1.182 to 2.473, P < 0.0001). Tranexamic acid infusion decreased hospital stay by about 2 days, and this difference was statistically significant (SMD = -3.929, 95% CI: -3.018 to -0.983, P = 0.0003). There was no adverse drug reaction in the course of the study. Conclusion: The use of tranexamic acid during myomectomy reduced intraoperative and postoperative blood loss. It is also associated with decreased hospital stay. This trial is registered with NCT04560465. Competing Interests: There is no conflict of interest. (Copyright © 2024 Ayodele Adegbite Olaleye et al.)
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سلسلة جزيئية:	ClinicalTrials.gov NCT04560465
تواريخ الأحداث:	Date Created: 20240129 Latest Revision: 20240131
رمز التحديث:	20240131
مُعرف محوري في PubMed:	PMC10810692
DOI:	10.1155/2024/2794052
PMID:	38283394
قاعدة البيانات:	MEDLINE

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تدمد:	2356-7104
DOI:	10.1155/2024/2794052