Role of Topical Tranexemic acid in reducing perioperative blood loss in Abdominal Hysterectomy.

  • Dr.Yasodha .S Shri Lakshmi Narayana Institute of Medical sciences, Puducherry, India
  • Dr Durga Krishnamurthy Associate professor,Sri LakshmiNarayana Institute of Medical Sciencess
  • Dr. Swetha.T Sri Laxami Narayana Institute of Medical Sciences, Puducherry, India
  • Dr Karthika K. Assistant Professor, Department of OBG, Kasturba Gandhi Hospital, Triplicane, Chennai 600005, Tamilnadu, India
Keywords: Tranexamic acid, Abdominal hysterectomy, Perioperative blood loss


Introduction: Intra-operative complications like torrential and uncontrollable blood loss are a nightmare for most of the surgeons. Intra-operative installation of topical tranexamic acid reduces the blood loss to a greater extent and decreases the requirement of blood transfusion. The present study is intended to study the effect of topical tranexamic acid in reducing blood loss during abdominal hysterectomies.

Objectives: To assess the efficacy of topical Tranexamic acid in reducing the perioperative blood loss in abdominal hysterectomy surgeries.

Materials and Methods: It is a randomized double-blind placebo-controlled trial conducted in Sri Lakshmi Narayana Institute of Medical Sciences, Puducherry. 100 women undergoing abdominal hysterectomy where randomly assigned to two groups: 50 patients received 100 ml normal saline IV served as the control group and another 50 patients who received 1 g topical tranexamic acid applied intra abdominally during hysterectomy served as the study group. The primary outcome was to assess intra-operative and postoperative blood loss.

Results: The study group (topical tranexamic acid application) showed marked reduction in intra-operative and post-operative blood loss (blood in the intra-abdominal drain) compared with control group (placebo group).

Conclusion: Topical Tranexamic acid application helps to prevent blood loss during and after major surgeries. It is safe drug which can be used with acceptable rate of complications. It improves postoperative morbidity and mortality


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Author Biographies

Dr.Yasodha .S, Shri Lakshmi Narayana Institute of Medical sciences, Puducherry, India

Working as an assistant professor in dept of obstretics and gynaecology 

Dr. Swetha.T, Sri Laxami Narayana Institute of Medical Sciences, Puducherry, India

Working as ASSISTANT PROFESSOR in Dept of obstretics and gynaecology..


Shekhar C, Paswan B2, Singh A. Prevalence, sociodemographic determinants and self-reported reasons for hysterectomy in India. Reprod Health. 2019;16(1):118. doi: 10.1186/s12978-019-0780-z.

Kongnyuy EJ, Wiysonge CS. Interventions to reduce haemorrhage during myomectomy for fibroids. Cochrane Database Syst Rev. 2014;(8):CD005355. doi: 10.1002/14651858.CD005355.pub5.

Watts G. Utako Okamoto. Lancet. 2016;387(10035):2286. doi: 10.1016/s0140-6736(16)30697-3.

World Health Organization. WHO model list of essential medicines: Archived (PDF) from the original on 13 December 2016. Retrieved 8 December 2016.

Lysteda (tranexamic acid) Package Insert" (PDF). Archived (PDF) from the original on 4 March 2016. Retrieved 2 November 2015.

Law RHP, Wu G, Leung EWW, Hidaka K , Quek AJ, Caradoc-Davies TT, et al. X-ray crystal structure of plasmin with tranexamic acid-derived active site inhibitors. Blood Adv. 2017;1(12):766-771. doi: 10.1182/bloodadvances.2016004150. eCollection 2017 May 9.

Rossaint R, Bouillon B, Cerny V, Coats TJ, Duranteau J, Fernández-Mondéjar E, et al. Management of bleeding following major trauma: an updated European guideline. Crit Care. 2010;14(2):R52. doi: 10.1186/cc8943. Epub 2010 Apr 6.

McCormack PL. Tranexamic acid: a review of its use in the treatment of hyperfibrinolysis. Drugs. 2012;72(5):585-617. doi: 10.2165/11209070-000000000-00000.

Melvin JS, Stryker LS, Sierra RJ. Tranexamic Acid in Hip and Knee Arthroplasty. J Am Acad Orthop Surg. 201;23(12):732-40. doi: 10.5435/JAAOS-D-14-00223. Epub 2015 Oct 22.

Tengborn L, Blombäck M, Berntorp E. Tranexamic acid--an old drug still going strong and making a revival. Thromb Res. 2015;135(2):231-42. doi: 10.1016/j.thromres.2014.11.012. Epub 2014 Nov 20.

WOMAN Trial Collaborators. Effect of early tranexamic acid administration on mortality, hysterectomy, and other morbidities in women with post-partum haemorrhage (WOMAN): an international, randomised, double-blind, placebo-controlled trial WOMAN Trial Collaborators. The Lancet. 2017;389(10084):2105-2116. doi: 10.1016/S0140-6736(17)30638-4. Epub 2017 Apr 26.

Cherkas D. Traumatic hemorrhagic shock: advances in fluid management". Emerg Med Pract. 2011;13(11):1–19, quiz 19–20.

Napolitano LM, Cohen MJ, Cotton BA, Schreiber MA, Moore EE. Tranexamic acid in trauma: how should we use it? J Trauma Acute Care Surg. 2013;74(6):1575-1586. doi: 10.1097/TA.0b013e318292cc54.

Ker K, Roberts I, Shakur H, Coats TJ. Antifibrinolytic drugs for acute traumatic injury. Cochrane Database of Systematic Reviews. 2015;9(5):CD004896. doi: 10.1002/14651858.CD004896.pub4..

David A, Paul A, Annette J, Dianne O, Barrie J, Fergusson, et al., (16 March 2011), "Anti-fibrinolytic use for minimizing perioperative allogeneic blood transfusion", in The Cochrane Collaboration (ed.), Cochrane Database of Systematic Reviews, John Wiley & Sons, Ltd, PMC 4234031.

Ker K, Edwards P, Perel P, Shakur H, Roberts I. Effect of tranexamic acid on surgical bleeding: systematic review and cumulative meta-analysis. BMJ. 2012;344:e3054. doi: 10.1136/bmj.e3054.

Ker K, Prieto‐Merino D, Roberts I. Systematic review, meta‐analysis and meta‐regression of the effect of tranexamic acid on surgical blood loss. Brit J Surg. 2013;100(10):1271-1279. doi: 10.1002/bjs.9193. Epub 2013 Jul 9.

Sethna NF, Zurakowski D, Brustowicz RM, Bacsik J, Sullivan LJ, Shapiro F. Tranexamic acid reduces intraoperative blood loss in pediatric patients undergoing scoliosis surgery. Anesthesiol. 2005;102(4):727-732. doi: 10.1097/00000542-200504000-00006.

British national formulary: BNF 69 (69th ed.). British Medical Association. 2015. p. 170. ISBN 9780857111562.

Allen H (13 June 2012). "Tranexamic acid for bleeding". Patient UK. Archived from the original on 25 May 2014.

Shakur H, Roberts I, Bautista R, Caballero J, Coats T, Dewan Y et al. Effects of tranexamic acid on death, vascular occlusive events, and blood transfusion in trauma patients with significant haemorrhage (CRASH-2): a randomised, placebo-controlled trial. Lancet. 2010;376(9734):23-32. doi: 10.1016/S0140-6736(10)60835-5. Epub 2010 Jun 14.

The CRASH-2 collaborators. The importance of early treatment with tranexamic acid in bleeding trauma patients: an exploratory analysis of the CRASH-2 randomised controlled trial”. Lancet. 2011;377(9711):1096–1101. doi:

Rossaint R, Bouillon B, Cerny V, Coats TJ, Duranteau J, Fernández-Mondéjar E, et al. The European guideline on management of major bleeding and coagulopathy following trauma. Crit care. 2016;20(1):100. doi:10.1186/s13054-016-1265-x.

DOI: 10.17511/joog.2019.i04.03
Published: 2019-10-31
How to Cite
S, Y., Krishnamurthy, D., T, S., & K., K. (2019). Role of Topical Tranexemic acid in reducing perioperative blood loss in Abdominal Hysterectomy. Obs Gyne Review: Journal of Obstetric and Gynecology, 5(4), 191-196.
Original Article