In the WOMAN trial (2017), tranexamic acid given within 3 hours of PPH onset was shown to reduce which specific outcome in women with postpartum hemorrhage?

• A Total blood transfusion requirement by more than 50%
• B Need for surgical intervention such as hysterectomy
• C Risk of death due to bleeding, without increasing thromboembolic events ✓
• D Incidence of PPH in women receiving oxytocin prophylaxis

Explanation

The WOMAN trial (World Maternal Antifibrinolytic Trial, Lancet 2017), the largest RCT of tranexamic acid in PPH (20,000 women), demonstrated that tranexamic acid significantly reduced death due to bleeding (1.5% vs 1.9%, RR 0.81) when administered within 3 hours of PPH onset. Importantly, there was no increase in thromboembolic complications. Tranexamic acid did NOT significantly reduce hysterectomy rates or overall blood transfusion volume. Time-sensitivity is critical — benefit was lost when given >3 hours after delivery.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.