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Tranexamic Acid for the Prevention of Blood Loss after Cesarean Among Women With Twins. A Secondary Analysis of the TRAAP2 Randomized Clinical Trial

dc.rights.licenseopenen_US
dc.contributor.authorSENTILHES, Loic
dc.contributor.authorMADAR, Hugo
dc.contributor.authorLE LOUS, Maela
dc.contributor.authorSENAT, Marie Victoire
dc.contributor.authorWINER, Norbert
dc.contributor.authorROZENBERG, Patrick
dc.contributor.authorKAYEM, Gilles
dc.contributor.authorVERSPYCK, Eric
dc.contributor.authorFUCHS, Florent
dc.contributor.authorAZRIA, Elie
dc.contributor.authorGALLOT, Denis
dc.contributor.authorKORB, Diane
dc.contributor.authorDESBRIERE, Raoul
dc.contributor.authorLE RAY, Camille
dc.contributor.authorCHAULEUR, Celine
dc.contributor.authorDE MARCILLAC, Fanny
dc.contributor.authorPERROTIN, Franck
dc.contributor.authorPARANT, Olivier
dc.contributor.authorSALOMON, Laurent J.
dc.contributor.authorGAUCHOTTE, Emilie
dc.contributor.authorBRETELLE, Florence
dc.contributor.authorSANANES, Nicolas
dc.contributor.authorBOHEC, Caroline
dc.contributor.authorMOTTET, Nicolas
dc.contributor.authorLEGENDRE, Guillaume
dc.contributor.authorLETOUZEY, Vincent
dc.contributor.authorHADDAD, Bassam
dc.contributor.authorVARDON, Delphine
dc.contributor.authorMATTUIZZI, Aurelien
dc.contributor.authorFROELIGER, Alizee
dc.contributor.authorBOUCHGHOUL, Hanane
dc.contributor.authorPHARM D., Valerie Daniel
dc.contributor.authorREGUEME, Sophie
dc.contributor.authorROUSSILLON, Caroline
dc.contributor.authorGEORGET, Aurore
dc.contributor.authorDARSONVAL, Astrid
hal.structure.identifierBordeaux population health [BPH]
dc.contributor.authorBENARD, Antoine
dc.contributor.authorDENEUX-THARAUX, Catherine
dc.date.accessioned2022-07-12T12:41:38Z
dc.date.available2022-07-12T12:41:38Z
dc.date.issued2022-06-18
dc.identifier.issn1097-6868 (Electronic) 0002-9378 (Linking)en_US
dc.identifier.urihttps://oskar-bordeaux.fr/handle/20.500.12278/140439
dc.description.abstractEnBACKGROUND: Although prophylactic tranexamic acid administration at cesarean delivery resulted in a lower incidence of calculated estimated blood loss > 1000 mL or red-cell transfusion by day 2, its failure to reduce the incidence of hemorrhage-related secondary clinical outcomes (TRAAP2 trial) makes its use questionable. The magnitude of its effect may differ in women at higher risk of blood loss, including those with multiple pregnancies. OBJECTIVE: To compare the effect of tranexamic acid vs placebo to prevent blood loss at cesarean delivery among women with multiple pregnancies. STUDY DESIGN: Secondary analysis of the TRAAP2 trial data including 319 women with multiple pregnancies in this double-blind, randomized controlled trial from March 2018 through January 2020 in 27 French maternity hospitals. Women with a cesarean before or during labor at 34 or more gestational weeks were randomized to receive intravenously 1 g of tranexamic acid (n=160) or placebo (n=159), both with prophylactic uterotonics. The primary outcome was a calculated estimated blood loss > 1000 mL or a red blood cell transfusion by 2 days after delivery. Secondary outcomes included clinical and laboratory blood loss measurements. RESULTS: Of the 4551 women randomized in this trial, 319 had a multiple pregnancy and cesarean delivery, 298 (93.4%) with primary outcome data available. This outcome occurred in 62 of 147 women (42.2%) in the tranexamic acid group and 67 of 152 (44.1%) receiving placebo (adjusted risk ratio, 0.97; 95% CI 0.68-1.38; P=.86). No significant between-group differences occurred for any hemorrhage-related clinical outcomes: gravimetrically estimated blood loss, provider-assessed clinically significant hemorrhage, additional uterotonics, postpartum blood transfusion, arterial embolization, and emergency surgery (P>.05 for all comparisons). CONCLUSION: Among women with a multiple pregnancy and cesarean delivery, prophylactic tranexamic acid did not reduce the incidence of any blood loss-related outcomes.
dc.language.isoENen_US
dc.subject.enBlood loss
dc.subject.enCesarean delivery
dc.subject.enMultiple pregnancy
dc.subject.enPostpartum hemorrhage
dc.subject.enPrevention
dc.subject.enTranexamic acid
dc.title.enTranexamic Acid for the Prevention of Blood Loss after Cesarean Among Women With Twins. A Secondary Analysis of the TRAAP2 Randomized Clinical Trial
dc.typeArticle de revueen_US
dc.identifier.doi10.1016/j.ajog.2022.06.019en_US
dc.subject.halSciences du Vivant [q-bio]/Santé publique et épidémiologieen_US
dc.identifier.pubmed35724759en_US
bordeaux.journalAmerican Journal of Obstetrics and Gynecologyen_US
bordeaux.hal.laboratoriesBordeaux Population Health Research Center (BPH) - UMR 1219en_US
bordeaux.institutionUniversité de Bordeauxen_US
bordeaux.institutionINSERMen_US
bordeaux.teamPHARES_BPHen_US
bordeaux.peerReviewedouien_US
bordeaux.inpressnonen_US
hal.identifierhal-03721202
hal.version1
hal.date.transferred2022-07-12T12:41:42Z
hal.exporttrue
dc.rights.ccPas de Licence CCen_US
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