WOMAN trial 2017

“Tranexamic acid reduces death due to bleeding in women with post-partum haemorrhage with no adverse effects. When used as a treatment for post-partum haemorrhage, tranexamic acid should be given as soon as possible after bleeding onset.”

Obstetric haemorrhage leading cause of maternal mortality world wide, most occurring in postpartum period.

Women with significant PPH demonstrate rapid clot lysis.

Antifibrinolytic agents are widely used in surgery to prevent clot breakdown (fibrinolysis) in order to reduce surgical blood loss.

World Maternal Antifibrinolytic trial

  • Large, well developed and well executed double-blinded, placebo-control RCT
  • Data suggests bleeding-death is reduced
  • Tranexamic acid does not appear to increase thromboembolic or other adverse events
  • Study issues included alteration of design during the study period and high NNT (267)
Bottom line:
Give Tranexamic Acid early in PPH – it might just help and shouldn’t cause harm.