Tranexamic acid for postpartum bleeding … and other research

Ann Robinson reviews the latest research Postpartum haemorrhage kills around 70 000 women a year. Since the results of the WOMAN trial in 2017, intravenous tranexamic acid given within three hours of birth has been the treatment of choice. Whether it can prevent postpartum haemorrhage remains unclear. Two important studies in the Lancet offer different perspectives. The WOMAN-2 trial, conducted in low and middle income countries, found that, in women with moderate or severe anaemia, giving 1 g tranexamic acid within 15 minutes of the umbilical cord being clamped did not reduce the risk of clinically diagnosed postpartum haemorrhage (>500 mL blood loss) compared with placebo (7% v 6.6%) and did not affect maternal mortality or adverse events. The second study was a large meta-analysis of five trials including studies from high income countries, …