DOI

10.21007/con.dnp.2025.0113

Faculty Advisor

Dwayne Accardo DNP, CCRN, FAANA

Document Type

Poster

Publication Date

Spring 4-29-2025

Disciplines

Emergency Medicine | Health and Medical Administration | Investigative Techniques | Maternal, Child Health and Neonatal Nursing | Medicine and Health Sciences | Nursing | Nursing Administration | Nursing Midwifery | Obstetrics and Gynecology | Perioperative, Operating Room and Surgical Nursing | Quality Improvement

Abstract

Purpose/Background

Globally, postpartum hemorrhage (PPH) is the leading cause of morbidity and mortality during the peripartum and postpartum period in delivering people. Emerging evidence suggests that combining second-line uterotonics with tranexamic acid (TXA) improves maternal outcomes, reduces blood loss, and lowers morbidity and mortality related to PPH (Jones et al., 2023; Al-dardery et al., 2023). TXA, an antifibrinolytic, enhances clotting, reduces blood loss, transfusion needs, hemoglobin drop, and the use of additional uterotonics (Bellos & Pergialiotis, 2021). This review highlights the benefits of TXA.

Methods

A scoping review required a literature search conducted from August 2023 to February 2024 using PubMed, CINAHL, and Google Scholar with terms like "cesarean section," "hemorrhage," "antifibrinolytics," "blood loss," "tranexamic acid," "oxytocin," and "postpartum hemorrhage." Inclusion criteria included studies in English involving pregnant women aged 18 or older undergoing cesarean delivery with oxytocin alone or with TXA. The initial return was 563 articles. After further refinement, ten relevant, high-quality articles were analyzed.

Results

Analysis of ten peer-reviewed studies revealed that TXA significantly reduces blood loss during cesarean deliveries. Eight studies showed reduced PPH rates, and nine reported less hemoglobin decline. Adverse events were rare, with one study noting seizures and renal dysfunction and another identifying thrombotic events. TXA demonstrated the potential to improve maternal outcomes with a generally safe profile.

Implications for Nursing Practice

TXA during cesarean deliveries significantly reduces blood loss and improves maternal outcomes, decreasing the need for additional uterotonics and transfusions. Its favorable safety profile and efficacy suggest TXA's integration into routine obstetric care. However, further rigorous studies are needed to address current limitations, refine dosing strategies, and evaluate long-term safety. Advancing research will help maximize TXA's benefits and enhance maternal health outcomes.

Download

Share

COinS