According to doctors, obstetric hemorrhages are among the most dangerous complications of pregnancy, which can threaten both the development of the fetus and the health of the woman herself. To eliminate blood loss medicine offers a number of drugs. Among them are drugs based on tranexamic acid, whose representative is Tranexam, produced in Russia and recommended for use by many domestic experts.
Tranexam - hemostatic drug for pregnant women
In a general sense, obstetric doctors understand bleeding associated with pathologies of the reproductive system organs, including the uterus, and occurring during pregnancy, during childbirth and the postpartum period. Causes of blood loss are quite diverse. Bleeding does not always indicate any violations. But in any case, they are the reason for the urgent consultation with a doctor.
Among the most common causes of doctors are the following:
- the threat of spontaneous abortion;
- ectopic pregnancy;
- placenta previa;
- premature detachment of the placenta;
- inflammation of the uterus;
- premature birth.
All of the above pathologies are dangerous for the normal development of the fetus. Moreover, by themselves, abundant blood loss violates placental metabolism between the body of a woman and the fetus. Also, the World Health Organization in recent years focuses on the timely prevention of bleeding precisely in the early stages. There is research data indicating that hematomas occur in the area of the placenta, which increase the risk of premature pregnancy and fetal growth retardation.Placental lump is one of the main causes of bleeding during pregnancy
For a timely stop of bleeding, maintaining the necessary viscosity of blood in the human body meets a special biological system, called hemostasis. If dangerous bleeding occurs, appropriate hemostatic preparations are used, which affect the mechanisms of blood coagulation and repair of damaged vessels. These drugs are divided into two main groups: coagulants and fibrinolysis inhibitors. The former directly affect the coagulability of blood, the latter - on the process of splitting and dissolving blood clots and clots, which is the final stage of hemostasis.
Principle of action, active substance and release form
Pharmacists prepare most fibrinolysis inhibitors synthetically based on the following acids:
Hemostatic drug Tranexam refers to inhibitors of fibrinolysis, manufactured on the basis of tranexamic acid. This acid inhibits the formation of a specific protein in the blood - plasmin, which affects the process of building a protective mesh for damaged vessels. According to some data, this substance is the most promising for the production of hemostatic drugs, since it is an order of magnitude more effective than aminocaproic acid. Tranexam meets all the necessary requirements for local and systemic hemostatic drugs used during pregnancy:
- does not affect the growth and development of the fetus;
- has a fast action, which is important in case of a threatened abortion;
- does not accumulate in the body with repeated use and therefore does not have a toxic effect;
- does not cause microthrombosis and does not impair the function of the placenta.
Also, when studying the properties of tranexamic acid, it was found that it suppresses the active substances involved in allergic reactions and inflammatory processes. Therefore, Tranexam is increasingly prescribed for allergies and respiratory diseases.
Through a combination of efficacy, safety, and availability, Tranexamic Acid is listed on the World Health Organization's list of essential drugs. Tranexam, in turn, is on the list of essential medicines, which is approved annually by the Government of Russia. The effect of tranexamic acid has been well studied in large-scale research around the world. This especially applies to problems with perioperative blood loss and postpartum hemorrhage.
Tranexam is available in the form of film-coated tablets and a solution for intravenous administration in ampoules. The tablets are made at the state-owned enterprise “Moscow Endocrine Plant”, and the means for injection is at the Obninsk Chemical and Pharmaceutical Company CJSC.Tranxam is available in the form of tablets and solution for injection.
According to official instructions, Tranexam can be used at any time during pregnancy, as it does not cause a teratogenic effect. In Russia, several research institutes conducted studies of the drug in pregnant women, the results of which confirmed the efficacy and safety of the drug. But the number of women participating in the studies was small and did not meet modern standards of Western medicine.
The active substance of the drug being considered, tranexamic acid, has been assigned a high safety category B by the Drug Control Administration of the United States Department of Health. This means that animal studies did not reveal a teratogenic effect on the fetus of this substance, and there was no proper standardized study in pregnant women.
Indications for appointment to expectant mothers
Tranexam is the drug of choice for uterine bleeding during pregnancy, which occurs for various reasons: from placental abruption to premature birth. Less common use of this drug for the following pathologies in expectant mothers:
- allergic reactions: urticaria, dermatitis, skin rashes, itching;
- inflammatory diseases of the respiratory and oral organs: tonsillitis, pharyngitis, laryngitis, tonsillitis, stomatitis;
- gastrointestinal bleeding.
Antifibrinolytic therapy with Tranexam significantly reduces blood loss and reduces the need for preparations of donated blood - erythrocyte mass and FFP.
THEIR. Hapiy, A.F. Lopatin
"Efficacy and safety of using Tranexam in surgical practice"
When to choose tablets, and in which solution
Tranexam tablets are suitable for use on an outpatient basis and are more often prescribed for minor blood loss and for their prevention. The solution is used when you want to stop the bleeding, directly threatening the health and life of the pregnant woman and the fetus. There are results of studies proving that immediate administration of tranexamic acid increased the survival rate of patients with acute traumatic and postpartum hemorrhages by 70%. Moreover, injections, unlike tablets, practically do not cause side effects associated with disorders of the gastrointestinal tract.
When buying Tranexam, you need to take into account that the tablets are sold in pharmacies without a prescription, and the ampoules are only prescribed.
Contraindications and side effects
Tranexam is considered a fairly safe drug. The main contraindication to the use of future mothers is the individual intolerance to the components of the drug. But the instruction notes that the medicine should be used with caution in the following pathologies:
- thrombosis, thrombophlebitis;
- hemorrhagic complications;
- the appearance of blood in the urinary tract;
- renal failure;
- disorders of color perception.
In treating tranexamic acid, unwanted reactions may occur in the expectant mother:
- allergy in the form of skin rashes and itching;
- gastrointestinal disorders: nausea, vomiting, diarrhea;
- dizziness, fatigue, decreased appetite;
- increased heart rate;
- violation of color perception and clarity of vision;
In the event of the occurrence of such phenomena, a pregnant woman should immediately consult a doctor who will change the treatment regimen or select another drug.
Interaction with other drugs
Doctors do not recommend combining Tranexam with other hemostatic drugs, as the risk of thrombosis increases. Also in the form of a solution, the medicine is incompatible with a number of medicines:
- blood products;
- solutions with penicillin, urokinase;
- solutions with hypertensives, tetracyclines, dipyridamole and diazepam.
As previously noted, Tranexam is most effective when used immediately. But a wide range of medication causes different treatment regimens. Dosage, frequency of treatment, duration of therapy during pregnancy is determined only by a doctor, who takes into account the individual characteristics of a woman.
In general, tablets are prescribed to pregnant women with a dose of 250-500 mg three to four times a day. They must be taken before the bleeding stops. Usually the duration of treatment is from five to ten days. The solution is used in cases of acute blood loss and can be administered drip or jet. A single dose is calculated from 15 mg per kilogram of mass. Injections are carried out every six to eight hours at a rate of 1 ml / min. It should be borne in mind that with a more rapid introduction may increase blood pressure.
Since Tranexam can cause visual impairment, if possible, before and during its use, you should be examined by an ophthalmologist to track changes.
Analogs allowed during pregnancy
Based on tranexamic acid, dozens of hemostatic drugs are produced. The following full analogues of Tranexam are available on the Russian pharmaceutical market:
In case of tranexamic acid intolerance, drugs such as Vikasol or Ditsinon may be prescribed to pregnant women.
Vikasol is a synthetic analogue of vitamin K, increases blood clotting and refers to coagulants. According to most experts during pregnancy, this drug can be administered only for serious reasons and with great caution. Although some sources indicate that when studying the effect of Vikasol on animals, an adverse effect of the drug on the development of the fetus was found. It is reported that increases the risk of hemolytic anemia and jaundice in the fetus and newborn.
The active ingredient of Ditsinona is etamzilat - a substance with a hemostatic effect, which, when administered intravenously, begins to be felt already after 5-15 minutes and lasts for four hours. During pregnancy, this medicine is prescribed by doctors, taking into account the ratio of benefit / risk.
Table: Tranexam and other hemostatics
|Main component||Tranexamic acid.||Menadione sodium bisulfite.||Etamzilat.|
|In what cases is assigned|
|Unwanted effects||The increase in blood levels of bilirubin, prothrombin.|
|Forms of release|
|price, rub.||From 249 for 10 tablets (250 mg).||From 23 for 30 tablets (15 mg).||From 347 per 100 tablets (250 mg).|
Photo Gallery: Tranexam analogues
- Troxaminat is a structural and functional analogue of Tranexam
- Vikasol is a synthetic analogue of vitamin K
- Dicine, along with Tranexam, is one of the most prescribed hemostatic drugs during pregnancy.
From regular communication with a familiar gynecologist, I made some conclusions about the appointment of hemostatic drugs. The recommendations of doctors change over time. It should be understood that Tranexam is a symptomatic drug that prevents large blood loss. If bleeding occurs during pregnancy, the reasons for it can be very diverse. In order to clarify them, numerous special examinations are often necessary, which sometimes lack time and effort. Therefore, doctors usually prescribe complex treatment with standard safe preparations based on their experience and clinical picture. Duphaston and Utrozhestan stand out among the most prescribed drugs, which increase the level of progesterone, which prevents miscarriages and premature labor. Also together with them to stop the bleeding, as a rule, appointed Ditsinon or Tranexam. Moreover, recently there has been an increase in the appointments of Utrozhestan and Tranexam. According to the doctor, the relative safety of these drugs allows them to be used even in the slightest suspicion of the threat of termination of pregnancy, without worrying that they will harm the development of the fetus. I can confirm that some of our friends and relatives have been helped by such drugs to carry out more than one child.
Video: why uterine bleeding occurs during the gestational period
Girls, while I drink tranexam and metacin, everything is fine. There is no discharge, nothing hurts. I stop drinking, after a day it starts to hurt, to pull the stomach, the beige discharge drop by drop to start again. Donated blood, normal values, allowed to drink tranexam for another 7 days. I'm tired already. Well that is. Tomorrow I'm on the ultrasound. I'm afraid.
I had a threat, saw tranexam. There were spotting. And even once the drip set with tranexam. He did not help me, the discharge went by itself. True, almost all the time lay. As you can see, the baby is already 6 months
In the end, I lay down for 2 weeks, all this time I was drinking tranexam 2-3 times, duphaston 2-3 times and proginous. By the end of the second week, the bleeding stopped. I checked out and went home. Thank God then everything was fine. Then they canceled tranexam, then they slightly lowered dufaston. When she did the ultrasound at 9 weeks they said that the placenta was rather small. But not critical. Then she did the ultrasound at 12 weeks - everything is normal and the baby is so wonderful. The doctor, to be honest, I do not remember already - a young girl, blonde, curly - she has, somehow, the approach to the patient depended on her mood. Since no one could really explain. I am very tired because of this. Now I would advise everyone to do an ultrasound in the same situation, to make sure that there are no hematomas or detachment, if everything is ok, then I’ll pass the bed on the hGH and hormones - I’ve decided for myself that I had this progesterone and estradiol most likely because of the low estradiol - and how it was brought back to normal, everything became good about erosion, despite the fact that it is quite large - everyone claimed that it was not about erosion!
So I have such parsley. I began to smear from 5 weeks to the sixth, I began to drink Tranexam increased the utrk, I lay down, I got tired of lying on the ultrasound, everything was fine by ultrasound. 6 weeks. After the ultrasound, it began to smear even more, then bloodied, running after the injections, prick ditsinon and progam plus utrik 400 per day, I lay for 4 days, everything is not bleeding well, I get up again this morning and this is with injections and the rest of the crap. She pricked the needle, went to the ultrasound well next to the house, on the ultrasound, a small hematoma, was told to lie on and prick. And get to the LCD. I came with an ultrasound and now the night has not even smeared, so I don’t understand what it is. According to the ultrasound the fruit is low. I sin on it.
In recent years, Tranexam has become increasingly popular with doctors and pregnant women with obstetric hemorrhages. The effectiveness of the drug is confirmed by the experience of its use and the results of research. For the future mother, it is important only to comply with the treatment regimen chosen by the doctor and not be shy to contact him for any troubling issues related to bleeding.