The WOMAN trial (World Maternal Antifibrinolytic Trial) demonstrated that tranexamic acid given within 3 hours of onset of PPH reduces death due to bleeding by what proportion, compared to placebo?
- A 31% relative reduction in death from bleeding (19% vs 13%) ✓
- B No significant reduction — the trial was negative for mortality
- C About 19% relative risk reduction with no time-sensitivity shown
- D Significant reduction only when given within 1 hour; no benefit at 1–3 hours
Correct answer: A. 31% relative reduction in death from bleeding (19% vs 13%)
Explanation
The WOMAN trial (2017, 20,000 women) showed tranexamic acid reduced death due to bleeding by 31% (relative reduction) when given within 3 hours of delivery. Death from PPH was 1.5% in the tranexamic group vs 1.9% in placebo (RR 0.81). There was a clear time-sensitivity: treatment within 3 hours was beneficial, with the greatest benefit within 1 hour. This established tranexamic acid as a WHO-recommended component of PPH management alongside uterotonics.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.