Infant Journal
for neonatal and paediatric healthcare professionals

Tranexamic acid use in the non-surgical neonatal population: a scoping review

Tranexamic acid (TXA) is recommended for use in paediatric major haemorrhage situations and paediatric surgery where major blood loss is anticipated. There are no recommendations regarding the use of TXA for major bleeding for neonates in a non-surgical context. This review evaluates existing literature relating to TXA use in neonates outside the surgical context. The limited available evidence indicates TXA can be a useful adjunct in management of neonatal non-surgical haemorrhage.

Jennifer Peterson1,2
Neonatal Sub-Speciality Trainee

Kate Pritchard3
Transport Advanced Neonatal Nurse Practitioner

Susan Kamupira2
Consultant Neonatologist

Ruth Gottstein2
Consultant Neonatologist

Ian Dady3
Consultant Neonatologist

1Faculty of Biology, Medicine and Health, University of Manchester
2Neonatal Intensive Care Unit, St Mary’s Hospital, Manchester
3Connect North West Neonatal Transport Team, St Mary’s Hospital, Manchester

Peterson J., Pritchard K., Kamupira S., Gottstein R., Dady I. Tranexamic acid use in the non-surgical neonatal population: a scoping review. Infant 2024; 20(2): 49-54.

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neonates; tranexamic acid; haemorrhage; bleeding; resuscitation
Key points
  1. This literature review looks at TXA use for major haemorrhage in neonates in the non-surgical context.
  2. TXA may be a useful adjunct for major haemorrhage in neonates with medical pathology.
  3. There is risk of dose-dependent adverse events with current TXA dosing regimens.

Also published in Infant:

Congenital myofibroma: an unusual neonatal presentation
The diagnosis of a vascular cutaneous appearing lesion in a neonate can be challenging. We report a case of a solitary congenital myofibroma presenting at birth as a major bleeding lesion. Further to the major haemorrhage and the ensuing hypoxia/ischaemia, the baby suffered multi-organ failure. This eventually led to redirection of care and neonatal death in about two weeks. On histopathological examination, the lesion showed a pattern identified as haemangio-pericytoma. This is a rare tumour involving blood vessels and soft tissues. In our literature search there is no other case report of a myofibromatous lesion presenting in this way. The importance of having an emergency haemorrhage protocol was highlighted with this incident.