EFFICACY OF TRANEXAMIC ACID IN THE MANAGEMENT OF POSTPARTUM HEMORRHAGE: AN INTEGRATIVE REVIEW OF SCIENTIFIC EVIDENCE

Abstract

Postpartum hemorrhage (PPH) is a leading cause of maternal mortality, especially in low- and middle-income countries. Tranexamic acid (TXA) has been widely used as an effective intervention to reduce mortality and complications associated with PPH. This integrative review was conducted based on the PICO strategy to assess the efficacy of TXA in the management of PPH. The search was conducted in databases such as PubMed, VHL, and SciELO, covering the period from 2014 to 2024, and resulted in the inclusion of 12 studies. The results indicate that TXA, when administered within the first three hours after the onset of hemorrhage, can reduce maternal mortality by up to 31%, as evidenced by the WOMAN Trial. In addition, other studies, such as the one by Oseni et al. (2021), have shown a 50% reduction in intraoperative blood loss in cesarean sections. The study by Novikova et al. (2015) highlighted the effectiveness of TXA in preventing severe bleeding, particularly in cesarean sections, by significantly reducing blood loss in excess of 1000 mL. However, the effectiveness of TXA is limited in settings with inadequate hospital infrastructure, compromising the full implementation of the intervention in low-income countries. It is concluded that TXA is a crucial intervention in the management of PPH, but its effectiveness depends on its early administration and better hospital conditions.