Introduction: Obstetric hemorrhage is one of the major causes of maternal morbidity and mortality. Blood loss during cesarean section is almost twice than that in vaginal delivery. The aim of this study was to evaluate the efficacy of tranexamic acid to reduce blood loss in cesarean section and its side effects. Methods: A comparative study was done in 100 women undergoing cesarean section between December 2015 to January 2017. The study group of 50 women received one gram intravenous tranexamic acid and the control group of 50 women did not receive tranexamic acid. Primary outcome measure was blood loss during cesarean section. Secondary outcome measures were drop in post-operative hemoglobin and hematocrit, change in pulse rate and blood pressure, need of additional uterotonics, auxiliary procedures to stop bleeding, blood transfusion rate and maternal and neonatal side effects of the drug. Results: Mean intraoperative blood loss in the study group was 443.62± 86.73ml; and in control group, 667.40±131.01ml (p<0.001). Mean postoperative drop in hemoglobin (g/dl) in the two groups were 0.82±0.27 and 1.86±0.64 respectively (p<0.001). Mean postoperative drop in hematocrit in the two groups were 2.60±0.91 and 5.49±1.97 respectively (p<0.001). Fourteen patients in the control group required additional uterotonics while none in the study group (p<0.001). There was no significant difference in the transfusion requirement (p=0.079). None of the mothers and the newborns had major side effects of drug. Conclusion: Tranexamic acid is a safe and effective drug to reduce blood loss in cesarean section.

Keywords: Blood loss, Cesarean section, Tranexamic acid