Early Tranexamic Acid Combined with an Active Hemorrhage Bundle Reduces Postpartum Blood Loss: A Comparative Cohort Study
Keywords:
postpartum hemorrhage, tranexamic acid, uterotonics, active management, maternal morbidity, quantitative blood loss, obstetric bundleAbstract
Background: Postpartum hemorrhage (PPH) remains a leading cause of preventable maternal morbidity, and adjunctive antifibrinolytic therapy combined with structured hemorrhage bundles has drawn renewed clinical interest. Objective: To evaluate whether early administration of tranexamic acid (TXA) combined with an active hemorrhage-response bundle reduces blood loss and related morbidity compared with standard uterotonic care. Methods: A prospective comparative cohort study enrolled 112 women delivering at the Perinatal Center of the Fergana Region (intervention group, oxytocin plus early TXA within an active bundle) and 112 women from the Andijan Regional Perinatal Center (standard oxytocin-only care) between 2023 and 2025. Quantitative blood loss, transfusion needs, and hemodynamic recovery time were compared. Results: The intervention group had significantly lower mean blood loss, PPH incidence, transfusion rates, and time to hemodynamic stabilization, with no increase in thromboembolic events. Conclusion: Early TXA integrated into an active hemorrhage bundle meaningfully improves postpartum bleeding outcomes and merits wider adoption in regional perinatal centers.
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