PB1409 - Evaluating the Haemostatic Effects of Tranexamic Acid in Women with Preeclampsia: an Experimental Ex Vivo Study

Tuesday, July 12, 2022

6:30 PM – 7:30 PM

Location: Exhibition

Presentation Format: In-Person

Presenting Author(s)

HO

Helen Chioma Okoye, FMCPath, FWACP

Consultant
Department of Haematology and Immunology, College of Medicine, University of Nigeria Ituku Ozalla Campus Enugu, Nigeria
Enugu, Enugu, Nigeria

Co-Author(s)

Maha Othman, MD PhD

Professor
Department of Biomedical and Molecular Sciences, School of Medicine, Queen's University, Kingston, Ontario, Canada,
Kingston, Ontario, Canada
Theresa U. Nwagha, MPH,FMCPatg

Consultant Haematologist
University of Nigeria , College of Medicine Ituku Ozalla Campus
Enugu, Enugu, Nigeria
DO

Daniel Onwusulu

Lecturer
Faculty of Medicine, Nnamdi Azikiwe University
Awka, Anambra, Nigeria
RO

Robinson Onoh

Professor
Alex Ekwueme Federal University Teachinh Hospital Abakaliki
Abakaliki, Ebonyi, Nigeria
CC

Chibuike Chigbu

Professor
College of Medicine, University of Nigeria, Ituku Ozalla campus, Enugu
Enugu, Enugu, Nigeria

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.