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Evaluating the Haemostatic Effects of Tranexamic Acid in Women with Preeclampsia: an Experimental Ex Vivo Study

1College of Medicine University of Nigeria Ituku Ozalla, Enugu, Enugu, Nigeria, 2Queen's University, Kingston, Ontario, Canada, 3College of Medicine / University of Nigeria Teaching Hospital, Enugu, Enugu, Nigeria, 4Faculty of Medicine, Nnamdi Azikiwe University, Awka, Anambra, Nigeria, 5Alex Ekwueme Federal University Teachinh Hospital Abakaliki, Abakaliki, Ebonyi, Nigeria, 6College of Medicine, University of Nigeria, Ituku Ozalla campus, Enugu, Enugu, Enugu, Nigeria

Abstract Number: PB1409

Meeting: ISTH 2022 Congress

Theme: Women’s Health » Pregnancy and Pregnancy Complications

Background: Tranexamic acid (TXA) use has gone beyond common indications like post-partum haemorrhage, and post-surgical bleeding. However, concerns remain around a potential increased risk of peripartum venous thromboembolism, more so in preeclampsia.

Aims: To evaluate the haemostatic effects of TXA ex-vivo in women with preeclampsia.

Methods: This was an ex-vivo study involving 45 normal pregnant women and 45 women with preeclampsia (9 mild and 36 with severe features) matched for age, gestational age and body mass index. The blood samples were collected, with informed consent, at the time of delivery and divided into 2 parts. The 1st served as the pre -TXA sample while the 2nd part was spiked with TXA and served as post-TXA sample. Plasma levels of D-Dimer and plasmin–antiplasmin complex (PAP) were determined using ELISA kits from Elabscience® Biotechnology Inc Texas USA. Ethical approval was obtained from Research Ethics Committee of University of Nigeria Teaching Hospital, Enugu. Statistical analysis was done using SPSS version 21.

Results: The mean D-dimer and PAP values in the pre-TXA samples differ significantly between groups. Following spiking with TXA, the mean D-dimer and PAP levels did not significantly differ in the pre-TXA vs post-TXA samples (p 0.560 and 0.500 respectively) in preeclampsia cohort. In normal pregnancy, the mean D-dimer levels in the post-TXA samples did not differ significantly (p=0.071) from the pre-TXA samples. However, the mean value of PAP in post-TXA samples was significantly higher (p = 0.048) than that of pre-TXA samples following TXA spiking.

Conclusion(s): Tranexamic acid did not have any significant effect on D-dimer and PAP levels in preeclampsia suggesting that it may not increase the thrombotic risks in preeclampsia patients. However, further large-scale studies are recommended to explore the in-vivo effects of TXA and the mechanism behind the differential effects in pre-eclampsia and normal pregnancy.

Table

Table 1: Comparing the pre- and post TXA samples using Paired t test.

Figure 1

Figure 1: Boxplot of pre- and post- Tranexamic acid in preeclampsia – 1a D-Dimer; 1b Plasmin antiplasmin complex -PAP-

To cite this abstract in AMA style:

Okoye H, Othman M, Nwagha T, Onwusulu D, Onoh R, Chigbu C. Evaluating the Haemostatic Effects of Tranexamic Acid in Women with Preeclampsia: an Experimental Ex Vivo Study [abstract]. https://abstracts.isth.org/abstract/evaluating-the-haemostatic-effects-of-tranexamic-acid-in-women-with-preeclampsia-an-experimental-ex-vivo-study/. Accessed October 1, 2023.

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