Obstetric Bleeding

Primary postpartum haemorrhage (PPH), is the leading cause of maternal death worldwide, responsible for around 100 000 deaths each year.

The WOMAN Trial evaluated the effect of tranexamic acid on death, hysterectomy and other surgical interventions and thromboembolic events in women with clinically diagnosed postpartum haemorrhage.   A total of 20,060 women with PPH were randomly allocated to receive tranexamic acid (1g intravenously) or matching placebo in addition to usual care. If bleeding continued, a second dose was given.

Death due to bleeding was significantly reduced with tranexamic acid (RR = 0·81, 95% CI 0·65–1·00, p=0·045), particularly in women treated within 3 hours of giving birth (RR =  0·69, 95% CI 0·52–0·91, p=0·008). All other causes of death did not differ significantly by group. Hysterectomy was not reduced with tranexamic acid (358 [3·6%] tranexamic acid vs 351 [3·5%] placebo; RR 1·02, 95% CI 0·88–1·07, p=0·84).

traumatic intra-cranial bleeding trial

Obstetric bleeding

Treatment within three hours of delivery reduces deaths due to bleeding by about one third.

 

Relative risk= 0.69 (0.53–0.90); p<0.001

Death Death Alive Alive
TXA
Control

Resources

All Videos

26. 06. 2017

WOMAN trial pre - publication video

Can we prevent women dying after childbirth? The WOMAN trial is a global investigation into maternal health to answer this question

26. 06. 2017

Picture your mother

Impact video on the reality of maternal mortality.

04. 09. 2017

Trial Results

Watch the WOMAN trial results - an interrogation on the charge of audacity

26. 06. 2017

WOMAN trial training video

This video describes the trial procedures of the WOMAN trial: an international, randomized, double-blind, placebo-controlled trial to determine the effect of the early administration of tranexamic acid on mortality, hysterectomy and other morbidities

26. 06. 2017

WOMAN documentary

The WOMAN Trial: Tranexamic for the treatment of PPH

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