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pph_tranexamic_acid_guideline__obstetrics_.pdf
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Tranexamic acid and PPH

Full guidance is in the document above.

Key points:
  • Tranexamic acid should be considered after blood loss of ≥ 1000ml during caesarean section or vaginal delivery (or if haemodynamically unstable).
  • Tranexamic acid 1g should be administered if bleeding is ≥ 1500ml.
  • If bleeding continues after 30 min or stops and restarts within 24 hours of the first dose, a second dose of 1 g of Tranexamic acid can be given.
  • Tranexamic acid should not be mixed with blood for transfusion or any intravenous penicillin preparations including Coamoxiclav
  • Tranexamic acid is considered safe for breast feeding mothers

Side effects:
  • Hypersensitivity reactions including anaphylaxis
  • Malaise and hypotension, with or without loss of consciousness, may be seen after rapid IV injection
  • Diarrhoea
  • Nausea and vomiting
  • •Dermatitis
  • •Impairment of colour vision – discontinue treatment if this occurs
  • Seizures - Cases of convulsions have been reported in association with Tranexamic acid treatment. In coronary artery bypass graft (CABG) surgery, most of these cases were reported following IV injection of Tranexamic acid in high doses. With the use of the recommended lower doses of Tranexamic acid, the incidence of post-operative seizures was the same as that in untreated patients.
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