Does tranexamic acid reduce mortality in women with postpartum hemorrhage?
EVIDENCE-BASED ANSWER:
Yes. When used in conjunction with the standard of care, 1 g intravenous (IV) tranexamic acid given 1 to 3 hours after delivery is associated with a significant reduction in maternal mortality from postpartum hemorrhage (PPH) (strength of recommendation: A, randomized controlled trial [RCT] and Cochrane review).
No known significant risks are associated with the use of tranexamic acid to treat PPH.
RECOMMENDATIONS
The newest practice guidelines on the management of postpartum hemorrhage published by the American College of Obstetricians and Gynecologists recommends considering tranexamic acid as an additional agent in managing PPH when initial standard-of-care treatments fail.3
Editor’s takeaway
The large international double-blind, randomized placebo-controlled trial provides convincing evidence that tranexamic acid should be administered readily in cases of PPH.
