Tranexamic acid for prevention of bleeding in cesarean delivery: An overview of systematic reviews
Autor: | Tomi Hurskainen, Joseph K. Burns, Leonardo Martin Calderon, Sylvain Boet, Mimi Xiaoming Deng, David Moher, Wesley Edwards, Cole Etherington |
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Rok vydání: | 2021 |
Předmět: |
medicine.medical_specialty
Blood transfusion medicine.medical_treatment MEDLINE Hemorrhage law.invention 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law Pregnancy medicine Humans Blood Transfusion 030212 general & internal medicine Cesarean delivery Intensive care medicine Adverse effect 030219 obstetrics & reproductive medicine business.industry General Medicine Antifibrinolytic Agents 3. Good health Anesthesiology and Pain Medicine Systematic review Data extraction Tranexamic Acid Female business Tranexamic acid medicine.drug Systematic Reviews as Topic |
Zdroj: | Acta anaesthesiologica ScandinavicaREFERENCES. 66(1) |
ISSN: | 1399-6576 |
Popis: | Background Bleeding is the leading cause of maternal mortality in the world. Tranexamic acid reduces bleeding in trauma and surgery. Several systematic reviews of randomized trials have investigated tranexamic acid in the prevention of bleeding in cesarean delivery. However, the conclusions from systematic reviews are conflicting. This overview aims to summarize the evidence and explore the reasons for conflicting conclusions across the systematic reviews. Methods A comprehensive literature search of Medline, Embase, and Cochrane Database of Systematic Reviews was conducted from inception to April 2021. Screening, data extraction, and quality assessments were performed by two independent reviewers. A Measurement Tool to Assess Reviews 2 and the Risk of Bias Assessment Tool for Systematic Reviews were used for study appraisal. A qualitative synthesis of evidence is presented. Results In all, 14 systematic reviews were included in our analysis. Across these reviews, there were 32 relevant randomized trials. A modest reduction in blood transfusions and bleeding outcomes was found by most systematic reviews. Overall confidence in results varied from low to critically low. All of the included systematic reviews were at high risk of bias. Quality of evidence from randomized trials was uncertain. Conclusions Systematic reviews investigating prophylactic tranexamic acid in cesarean delivery are heterogeneous in terms of methodological and reporting quality. Tranexamic acid may reduce blood transfusion and bleeding outcomes, but rigorous well-designed research is needed due to the limitations of the included studies. Data on safety and adverse effects are insufficient to draw conclusions. |
Databáze: | OpenAIRE |
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