Use of tranexamic acid to reduce blood loss and associated complications during hysterectomy

DOI

https://dx.doi.org/10.18565/aig.2022.312

Kolodina M.I., Titova M.S., Lyashenko A.S., Lyashenko E.N.
1) Institute “S.I. Georgievsky Medical Academy, V.I. Vernadsky Crimean Federal University, Simferopol, Russia; 2) City Polyclinic No. 17, Saint Petersburg, Russia

This literature review is aimed at summarizing the results of using tranexamic acid (TA), its benefit and safety in practice during hysterectomy. The scientific papers available in the PubMed, MEDLINE, Embase, eLIBRARY, CyberLeninka, and Google Scholar were systematically sought using the search terms “hysterectomy”, “tranexamic acid”, and “use of tranexamic acid during surgical operations” are analyzed. The authors have analyzed six investigations involving 193 616 patients. Hysterectomy belongs to common operations performed in surgical gynecology in the most countries of the world. To reduce blood loss and to prevent possible complications, various mechanical and pharmacological methods are applied. These include the use of TA that a synthetic derivative of lysine and included by the World Health Organization (WHO) into the list of essential medicines. Due to the local and systemic hemostatic effect, this substance is used in bleeding, in the pathogenesis of which a role is played by enhanced fibrinolysis. Fibrinolysis is pharmacologically inhibited by the capacity of TA to link to the binding sites in the molecule of plasmin and so to break its interaction with fibrin and other substrates. TA is well tolerated; its adverse reactions include nausea, vomiting, diarrhea, and allergy; orthostatic collapse is rarely seen. The literature has described the effective use of this agent to reduce blood loss, which finally decreases the need for transfusion and death rates in the patients.
Conclusion: The results of the analysis made by the authors point to the safety and efficacy of TA. Nevertheless, it is necessary to conduct further investigations to confirm these results in a larger number of patients for the more effective application of this substance.

Authors' conclusions: Titova M.S., Kolodina M.I. – concept of the article, material collection, processing, analysis, writing the text; Titova M.S., Kolodina M.I., Lyashenko A.S. – editing; Lyashenko E.N., Lyashenko A.S. – approval of the final version of the article.
Conflicts of interest: The authors declare there are no conflicts of interest.
Funding: The investigation has not been sponsored.
For citation: Kolodina M.I., Titova M.S., Lyashenko A.S., Lyashenko E.N. Use of tranexamic acid to reduce blood loss and associated complications during hysterectomy.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2023; (5): 140-145 (in Russian)
https://dx.doi.org/10.18565/aig.2022.312

tranexamic acid

hysterectomy

bleeding during hysterectomy

use of tranexamic acid in bleeding

bleeding

Full text (in Russian)

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Received 23.12.2022

Accepted 15.05.2023

Maria I. Kolodina, 6th year student of the 2nd Faculty of Medicine, Institute "S.I. Georgievsky Medical Academy", V.I. Vernadsky Crimean Federal University,
295051, Russia, Republic of Crimea, Simferopol, Lenin Boulevard, 5/7, kolodinamariauvanovna@mail.ru, https://orcid.org/0000-0002-5478-5101
Margarita S. Titova, 5th year student of the 2nd Faculty of Medicine, Institute "S.I. Georgievsky Medical Academy", V.I. Vernadsky Crimean Federal University,
295051, Russia, Republic of Crimea, Simferopol, Lenin Boulevard, 5/7, +7(978)895-97-98, titova.margo00@mail.ru, https://orcid.org/0000-0002-4476-0955
Anastasia S. Lyashenko, therapist, City Polyclinic No. 17, 195176, Russia, St. Petersburg, Metallistov Ave., 56, grobovaya98@mail.ru,
https://orcid.org/0000-0002-0284-7649
Elena N. Lyashenko, PhD, Associate Professor at the Department of Obstetrics and Gynecology No. 2, Institute "S.I. Georgievsky Medical Academy", V.I. Vernadsky
Crimean Federal University, 295051, Russia, Republic of Crimea, Simferopol, Lenin Boulevard, 5/7, helen.lyashen@mail.ru, https://orcid.org/0000-0002-4350-5020
Corresponding author: Margarita S. Titova, titova.margo00@mail.ru

Use of tranexamic acid to reduce blood loss and associated complications during hysterectomy

Kolodina M.I., Titova M.S., Lyashenko A.S., Lyashenko E.N.

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