Abruptio placentae--treatment with the fibrinolytic inhibitor tranexamic acid.

Abruptio placentae is known to have a bad prognosis for the fetus. Pathologic proteolysis, e.g. a pathologic activation of the coagulation mechanism and/or the fibrinolytic system is known to be a common complication in such cases. Analysis of the coagulation factors and components of the fibronlytic system in the acute stage of 14 cases confirmed the earlier finding of mainly an activation of the fibrinolytic system, which argues for the use of a specific inhibitor. 73 consecutive cases of abruptio placentae were treated with tranexamic acid in the acute stage. 67 of the patients were immediately delivered by cesarean section. The remaining six patients were in early gestational age and were treated for a prolonged period. The perinatal mortality of the entire group was only 8 per cent and the maternal mortality nil. None of the cases were complicated by hemorrhagic diathesis or thromboses. We believe that routine immediate treatment with tranexamic acid can reduce the perinatal mortality in cases of abruptio placentae.