Prophylactic tranexamic acid in Cesarean delivery: an updated meta-analysis with a trial sequential analysis
Authors' conclusion
Prophylactic TXA administration for parturients undergoing Cesarean delivery significantly reduced blood loss, without increasing adverse events, supporting its use as a safe and effective strategy for reducing PPH in this population.
Study context
- Population
- Parturients undergoing Cesarean delivery
- Participants
- 22,940 participants · 38 randomized controlled trials (RCTs)
- Comparison
- Prophylactic tranexamic acid (TXA) vs placebo or no treatment
- TXAn = 11,535
- Outcome
- Main outcomes: PPH, any blood transfusion, need for additional uterotonics, and adverse events
Methodological detailstrial sequential analysis
- Trial sequential analysis
Pooled result
As reported in the abstract
TXA vs Placebo or no treatmentRelative risk (95% CI)P value
PPH
0.51(0.38–0.69)
P < 0.001Blood transfusion
0.43(0.30–0.61)
P < 0.001Additional uterotonics
0.52(0.40–0.68)
P < 0.001Safety
Adverse effects and thromboembolic events
- No significant differences between the groups
Original publication
Prophylactic tranexamic acid in Cesarean delivery: an updated meta-analysis with a trial sequential analysis. Can J Anaesth. Published 7 March 2024. doi:10.
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