In the WOMAN trial (World Maternal Antifibrinolytic Trial), administration of tranexamic acid within 3 hours of PPH diagnosis reduced which specific outcome compared to placebo?

• A Total PPH-related death and hysterectomy combined
• B Total blood transfusion requirement at 24 hours
• C Uterine atony requiring additional uterotonics
• D Death due to bleeding, without reduction in hysterectomy rates ✓

Explanation

The WOMAN trial (Lancet 2017) found that tranexamic acid significantly reduced death due to bleeding (RR 0.81) when given within 3 hours of PPH, but did not reduce total hysterectomy rates or total deaths from all causes. The benefit was time-sensitive — administration beyond 3 hours showed no mortality benefit. This has been incorporated into WHO guidelines recommending TXA within 3 hours of delivery for PPH. It did not significantly reduce transfusion requirements as a primary outcome.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.