Table 1 Summary of included studies
Randomized Controlled Trial (RCT) | ||||||
|---|---|---|---|---|---|---|
Author | Year | Country | Patients (n) a | Intervention, TXA | Control | Uterotonic standard prophylaxis |
Ali Movafegh [15] | 2011 | Iran | 100 (50/50) | 10Â mg/kg TXA in 200Â mL of normal saline, IV. 20Â min before beginning spinal anesthesia, over 10Â min | 200Â mL of normal saline, IV. 20Â min before beginning spinal anesthesia, over 10Â min | 10Â IU oxytocin in 500Â mL of normal saline IV, after delivery of the placenta, over 20Â min |
H. Abdel-Aleem [16] | 2013 | Egypt | 740 (373/367) | 1Â g/10Â mL TXA diluted with 20Â mL of 5% glucose, IV. before the operation commenced, over 10Â min | No treatment | 5Â IU oxytocin IV bolus and 20Â IU oxytocin intravenous infusion |
Mehmet B. Sentu ̈rk [17] | 2013 | Turkey | 223 (101/122) | 1 g of TXA diluted with 20 mL of 5% glucose, IV. 10 min before skin incision, over 5 min | 20 mL of 5% glucose, IV. 10 min before skin incision, over 5 min | 20 IU oxytocin IV in bolus form after removal of placenta |
Anuradha Ghosh [18] | 2014 | India | 140 (70/70) | 1Â g/10Â mL TXA, IV. before skin incision | 10Â mL of sterile water, IV. before skin incision | 20Â IU oxytocin during the first 8Â h post operatively |
Haitham Torky [19] | 2021 | Egypt | 120 (60/60) | 1 g/10 mL TXA, IV. 20 min before the procedure | 10 mL normal saline, IV. 20 min before the procedure | 10 IU oxytocin IM + 10 IU oxytocin IV, immediately after delivery |
Abd El-Naser Abd El-Gaber [20] | 2019 | Egypt | 500 (250/250) | 1Â g of TXA, IV. 10Â min before skin incision, over 2Â min | normal saline, IV. 10Â min before skin incision, over 2Â min | 10Â IU oxytocin in 500Â mL of normal saline IV, after the delivery of baby, over 15Â min |
Forozan Milani [21] | 2019 | Iran | 60 (30/30) | 1Â g of TXA diluted in 20Â mL of 5% distilled water, IV. 15Â min before skin incision. 15Â min before skin incision | 10Â mL distilled water diluted in 20Â mL of 5% distilled water, IV. 15Â min before skin incision | 30Â IU oxytocin in 1L ringer lactate IV, after the delivery |
Zahra Naeiji [22] | 2021 | Iran | 200 (100/100) | 1 g/10 mL (body weight < 90 kg) or 1.5 g/15 mL (body weight > 90 kg) diluted in 15 mL of 5% dextrose, IV. just before skin incision | 5 mL of distilled water in 15 mL of 5% dextrose, IV. just before skin incision | 20 IU oxytocin in 500 mL normal saline, IV, 8 mU/min, after delivery |
Amr H. Yehia [23] | 2014 | Egypt | 212 (106/106) | 1Â g/10Â mL TXA, IV. with induction of anesthesia, over 2Â min | No treatment | 10Â IU oxytocin, IV. after delivery of the baby |
Cohort Studies | ||||||
Upasana Goswami [24] | 2013 | India | 60 (30/30) | 10Â mg/kg TXA in 20Â mL of 5% dextrose, IV. 20Â min before skin incision | 5Â mL of distilled water in 20Â mL of 5% dextrose, IV. 20Â min before skin incision | 20Â IU oxytocin in 500Â mL normal saline, IV, 8Â mU/min, after delivery of the neonate |
Ming-ying Gai [25] | 2004 | China | 180 (91/89) | 1 g/10 mL TXA diluted with 20 mL of 5% glucose, IV. 10 min before incision, over 5 min | No treatment | 10 IU oxytocin IV + 20 IU oxytocin into the intra-uterine wall after delivery of the neonate |
Tullika Singh [26] | 2014 | India | 200 (100/100) | 1Â g of TXA, slowly IV. 20Â min before skin incision, over 5Â min | No treatment | 20Â IU oxytocin in 500Â mL of ringer lactate, after delivery of baby |
A. V. Chandak [27] | 2017 | India | 100 (50/50) | 1Â g of TXA, slowly IV. 20Â min before skin incision, over 5Â min | No treatment | 20Â IU oxytocin in 500Â mL normal saline, IV, 8Â mU/min, after delivery of the neonate |
Leila Sekhavat[28]Â | 2009 | Iran | 90 (45/45) | 1Â g/10Â mL TXA, IV. 10Â min before incision, over 5Â min | 10Â mL of 5% glucose, slowly IV. 10Â min before incision, over 5Â min | 10Â IU oxytocin in 500Â mL dextrose normal saline, over 30Â min, after delivery |
Irene Ray [29] | 2016 | India | 100 (50/50) | 1 g/10 mL TXA in 20 mL of 5% dextrose solution, IV. 20 min before beginning of spinal anesthesia | 30 mL of 5% dextrose solution, IV. 20 min before beginning of spinal anesthesia | 10 IU oxytocin in 500 mL of normal saline IV, over 20–30 min, after delivery |
S.J. Dhivya Lakshmi [30] | 2016 | India | 120 (60/60) | 1Â g/10Â mL TXA in 100Â mL of normal saline, IV. at least 20Â min before skin incision, over 15Â min | No treatment | 10Â IU oxytocin added to ringer lactate, 75 to 100Â mL/h for 3Â h after surgery |
Khing Rushulo [31] | 2016 | India | 60 (30/30) | 10 mg/kg of TXA, IV. 10 min before skin incision, over 5 min | 10 mL normal saline, IV. 10 min before skin incision, over 5 min | 10 IU oxytocin IM + 20 IU oxytocin in a pint of ringer’s lactate for 2 h IV, after delivery of neonate |
P. Malathi [32] | 2016 | India | 200 (100/100) | 10 mg/kg of TXA, IV. 15–20 min before spinal anesthesia | No treatment | 10 IU oxytocin IM + 10 IU oxytocin in 500 mL lactated Ringer solution IV, after cord clamping, over 30 min |
Samir Abd Allah Ali [33] | 2019 | Egypt | 200 (100/100) | 1Â g of TXA in 200Â mL normal saline, IV. 20Â min before skin incision | No treatment | 5Â IU oxytocin in 500Â mL normal saline IV, after delivery of the neonate, over 30Â min |
Ayman A. Soliman [34] | 2021 | Egypt | 100 (50/50) | 1 g/10 mL TXA, IV. 20 min before skin incision. over 10 min | No treatment | 20 IU oxytocin in 500 mL normal saline, IV. after delivery of fetus, over 20–30 min |
Noshina Shabir [35] | 2019 | Pakistan | 100 (50/50) | 1 g/10 mL TXA in 20 mL of 5% dextrose, IV. 20 min before spinal anesthesia | 30 mL of 5% dextrose, IV. 20 min before spinal anesthesia | 10 IU oxytocin in 500 mL normal saline, IV. after delivery, over 20–30 min |