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


Maternal anaemia and the risk of postpartum haemorrhage: a cohort analysis of data from the WOMAN-2 trial

Finding Better Ways to Prevent Postpartum Hemorrhage

Tranexamic acid for the prevention of postpartum bleeding in women with anaemia: study protocol for an international, randomised, double-blind, placebo-controlled trial


Other publications


Effect of early tranexamic acid administration on mortality, hysterectomy, and other morbidities in women with post-partum haemorrhage (WOMAN): an international, randomised, double-blind, placebo-controlled trial

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.