Journal article
Implementation of a guideline of early administration of tranexamic acid for severe primary postpartum haemorrhage: a retrospective comparative study
Australian & New Zealand Journal of Obstetrics & Gynaecology, Vol.61(3), pp.354-359
2021
PMID: 33350456
Abstract
Background: Since the WOMAN trial, intravenous tranexamic acid (TXA) has been increasingly used in severe postpartum haemorrhage (PPH) but research evaluat-ing use in high-income settings is limited.Aims: To assess whether implementation of a new guideline involving early ad-ministration of 1 g intravenous TXA in active PPH with blood loss ≥ 1000 mL, was associated with a change in maternal morbidity.Materials and Methods: Retrospective study of all singleton, term, vaginal births from November 2016 to June 2019 with a PPH of ≥1000 mL, before and after hos-pital adoption of a guideline recommending early (within three hours of birth) administration of TXA for women with active PPH ≥ 1000 mL. Univariate analysis assessed the impact of this guideline implementation on a primary outcome of ma-ternal morbidity, defined as one or more of haemoglobin < 90 g/L, administration of blood products, hysterectomy or intensive care admission. Secondary outcomes were adverse events related to administration of TXA, use of an intrauterine bal-loon or postpartum iron infusion.Results: There was no difference in morbidity (odds ratio (OR) 0.86, 95% CI 0.57–1.29, P = 0.46) or postpartum iron infusion (OR 1.44, 95% CI 0.92–2.27, P = 0.11), but there was a reduction in the use of intrauterine balloon tamponade after the implementation of the TXA guideline (OR 0.33, 95% CI 0.16–0.67, P < 0.01).Conclusions: This retrospective analysis showed a reduced use of intrauterine bal-loon but failed to show a benefit in maternal morbidity with early administration of TXA for severe postpartum haemorrhage in a high-income setting.
Details
- Title
- Implementation of a guideline of early administration of tranexamic acid for severe primary postpartum haemorrhage: a retrospective comparative study
- Authors
- Leah Watkins (Corresponding Author) - Sunshine Coast University Hospital (Australia)Lauren Kearney (Author) - Sunshine Coast University Hospital (Australia)Mary Kynn (Author) - University of the Sunshine Coast, Queensland, School of Health and Sport Sciences - LegacyCaitlin Hodgman (Author) - Sunshine Coast University Hospital (Australia)Rachael Nugent (Author) - Sunshine Coast University Hospital (Australia)
- Publication details
- Australian & New Zealand Journal of Obstetrics & Gynaecology, Vol.61(3), pp.354-359; 6
- Publisher
- Wiley-Blackwell Publishing Asia
- Date published
- 2021
- DOI
- 10.1111/ajo.13282
- ISSN
- 1479-828X
- PMID
- 33350456
- Organisation Unit
- University of the Sunshine Coast, Queensland; School of Health and Sport Sciences - Legacy; School of Nursing, Midwifery and Paramedicine - Legacy; School of Health and Behavioural Sciences - Legacy
- Language
- English
- Record Identifier
- 99498108202621
- Output Type
- Journal article
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- Collaboration types
- Domestic collaboration
- Web Of Science research areas
- Obstetrics & Gynecology
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