Maintaining Postpartum Bleeding: Effects of Tranexamic Acid
Background/Purpose: The purpose of this literature appraisal is to determine the effectiveness of tranexamic acid (TXA) and its ability to stabilize postpartum bleeding. TXA is an antifibrinolytic pharmacologic drug found to reduce blood loss associated with trauma and patients undergoing major surgeries. When administered in combination with other uterotonics, the World Health Organization predicts the prophylactic use of TXA could globally improve the morbidity and mortality rates associated with postpartum hemorrhaging. Theoretical Framework: Kurt Lewin’s change theory was used in the development of this literature review. The Lewin change theory emphasizes the importance of change and development within a medical institution. Lewin’s theory is categorized into three stages consisting of the unfreezing, change, and refreezing models. Methods: Twenty research articles that pertained to postpartum hemorrhaging and/or the effects of TXA on postpartum bleeding were assessed. The Johns Hopkins research evidence appraisal tool was used to evaluate all articles included in this literature appraisal. Results/Findings: The need for TXA among various maternal groups was assessed. High risk patients were found to be in greater need for TXA during postpartum care. TXA has also been found to reduce the need for uterotonics, improve hemoglobin and hematocrit levels, and decrease rates of postpartum hemorrhaging. Potential adverse effects and costs associated with TXA use were also explored. Implications for Research and Practice: The prophylactic use of TXA is significant to midwifery and caring for women. Midwives may administer TXA to reduce the patient’s risk of maternal death and injury related to postpartum bleeding. The use of TXA is particularly The use of TXA is particularly important for healthy postpartum transitions among at-risk patients and patients in developing nations.