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Applications of Tranexamic acid in benign gynecology

Klebanoff, Jordan S.a; Marfori, Cherie Q.a; Ingraham, Caitlin F.b; Wu, Catherine Z.a; Moawad, Gaby N.a

Current Opinion in Obstetrics and Gynecology: April 22, 2019 - Volume Publish Ahead of Print - Issue - p
doi: 10.1097/GCO.0000000000000547
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Purpose of review Bleeding at the time of benign gynecologic surgery, as well as from benign gynecologic conditions, is a major source of morbidity for many women. Few nonhormonal medical options exist for the treatment of heavy menstrual bleeding, and to reduce surgical bleeding during major gynecologic surgery. Interest in Tranexamic acid (TXA) as a means to reduce surgical blood loss has been growing across many surgical specialties. This review focuses on applications for TXA as a means to reduce heavy menstrual bleeding (HMB) as well as to reduce surgical bleeding during benign gynecologic surgery.

Recent findings Tranexamic acid is an effective treatment to reduce the volume of bleeding during menstruation. Tranexamic acid was found to be superior to both placebo and oral progestins, and as good as combined oral contraceptives at reducing menstrual blood volume. Tranexamic acid has also been show to reduce the volume of bleeding during abdominal myomectomy as well as hysterectomy. There is a major need for prospective studies evaluating the utility of TXA for reducing blood loss during benign gynecologic surgery.

Summary Tranexamic acid has been found to be an excellent affordable nonhormonal treatment option for women with HMB and should be considered during major gynecologic surgery.

aDivision of Minimally Invasive Gynecology, Department of Obstetrics and Gynecology, The George Washington University Hospital, Washington, DC

bDepartment of Obstetrics and Gynecology, Christiana Care Health System. Newark, Delaware, USA

Correspondence to Jordan S. Klebanoff, MD, Department of Obstetrics and Gynecology, The George Washington University Hospital, Department of Obstetrics & Gynecology, 2150 Pennsylvania Ave NW, Washington, DC 20037, USA. E-mail: Jsk5068@gmail.com

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