DOI: 10.36347/sjams.2018.v06i12.078

Pages: 5089-5094

Background: Hysterectomy, the second most common surgery for women, addresses issues like severe pelvic pain, irregular bleeding, and cancer, often for those unresponsive to medication or not planning more children. It can be performed abdominally, vaginally, or laparoscopically, with abdominal procedures being the most common worldwide. Blood loss is a significant risk, especially for those with anemia or heart disease. Tranexamic acid (TA) and other antifibrinolytics help reduce bleeding, though side effects like nausea and, in severe cases, hypotension can occur. Aim of the study: This study aims to evaluate the effect of prophylactic tranexamic acid on blood conservation in women undergoing abdominal hysterectomy. Methods: In this prospective comparative study at the Department of Obstetrics and Gynaecology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh., over one year from June 2017 to July 2018, 124 women undergoing abdominal hysterectomy were randomized into two groups: Group A (n=62), receiving tranexamic acid (TXA), and Group B (n=62), receiving a normal saline placebo. The study aimed to evaluate TXA’s effect on blood loss, which was measured using the gravimetric method and hemoglobin levels 24 hours post-surgery. All patients underwent preoperative evaluation and postoperative monitoring for adverse events, including daily Doppler ultrasound for deep vein thrombosis (DVT) detection. Blood transfusion requirements and surgery duration were also assessed across both groups. Result: Group A (TXA) had a mean age of 37.68 years and required perioperative blood transfusions in only 11.29%, while Group B (placebo) had a mean age of 41.52 years and required transfusions in 41.94% (P=0.0007). Estimated blood loss was significantly lower in Group A (361.65±106.3 mL) compared to Group B (538.21±123.6 mL). Group A also had a shorter surgery duration (125.84±16.38 minutes vs. 146.74±15.37 minutes). The most common indication was fibromyoma (3