In October 2024, the WOMAN Trials Collaborators published two papers in The Lancet, which revealed important evidence on the effects of the drug tranexamic acid (TXA) on postpartum haemorrhage (PPH) and life-threatening bleeding after childbirth.
The first study, an individual patient data (IPD) meta-analysis found that TXA substantially reduces life-threatening bleeding after childbirth, regardless of the type of birth (vaginal or caesarean) or the presence or absence of anaemia. The analysis showed that TXA cut the risk of life-threatening bleeding by nearly one quarter.
A second paper reported the results of the WOMAN-2 Trial, which found that women with moderate and severe anaemia had a much higher risk of PPH, but there was no reduction in the risk of PPH with TXA.
Publications
WOMAN-2 publications
Tranexamic acid for postpartum bleeding: a systematic review and individual patient data meta-analysis of randomised controlled trials, Ker, Katharine et al. The Lancet, Volume 404, Issue 10463, 1657 – 1667
The effect of tranexamic acid on postpartum bleeding in women with moderate and severe anaemia (WOMAN-2): an international, randomised, double-blind, placebo-controlled trial, The Lancet, Volume 404, Issue 10463, 1645 – 1656
Finding Better Ways to Prevent Postpartum Hemorrhage
Other publications
Postpartum haemorrhage in anaemic women: assessing outcome measures for clinical trials
Further resources
TXA central is a resource for health professionals caring for people with acute bleeding
TXA central brings together randomised trial evidence on the effectiveness and safety of tranexamic acid
Data on many of the trials are also available at the freeBIRD website.