The WOMAN trial (World Maternal Antifibrinolytic Trial) evaluated tranexamic acid in PPH. Its key finding regarding optimal timing of administration was that mortality benefit is seen only when tranexamic acid is given within:

• A 30 minutes of PPH diagnosis
• B 3 hours of PPH onset ✓
• C 1 hour of PPH onset
• D 6 hours of PPH onset

Explanation

The WOMAN trial (2017) showed that tranexamic acid reduced death from PPH bleeding significantly when given within 3 hours of delivery; beyond 3 hours, there was no mortality benefit and a non-significant increase in thromboembolic events. Tranexamic acid acts by competitively inhibiting plasminogen activation, thereby preventing fibrinolysis. The current WHO recommendation is to administer tranexamic acid (1 g IV) within 3 hours of PPH onset in addition to uterotonics. This time-sensitive benefit mirrors findings in the CRASH-2 trial for traumatic hemorrhage.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.