The Use of Tranexamic Acid for the Treatment of Postpartum Hemorrhage: A Systematic Review

Abstract

Introduction: Postpartum hemorrhage (PPH) is a life-threatening obstetric emergency. Tranexamic acid (TXA), an antifibrinolytic agent, has been investigated as an adjunctive therapy to reduce blood loss and mortality. This review assesses its efficacy.

Methods: A search of MEDLINE and CENTRAL was conducted for placebo-controlled RCTs of TXA in women with clinically diagnosed PPH. The primary outcome was a composite of death from all causes or hysterectomy.

Results: The review was dominated by a single, large, multinational RCT. The trial showed that the administration of TXA significantly reduced death due to bleeding, particularly when given within three hours of birth. It did not increase the risk of thromboembolic events.

Discussion: TXA is a low-cost, easily administered medication that can be a life-saving intervention in cases of PPH. Its mechanism of stabilizing blood clots is a crucial adjunct to standard uterotonic and surgical management.

Conclusion: Early administration of tranexamic acid reduces mortality due to bleeding in women with postpartum hemorrhage.