In the WOMAN trial (World Maternal Antifibrinolytic Trial), tranexamic acid administered within 3 hours of PPH onset significantly reduced which outcome?

• A Overall PPH-related mortality when given regardless of time from delivery
• B Need for surgical intervention and hysterectomy
• C Incidence of thromboembolic complications in treated women
• D Death due to bleeding when given within 3 hours of delivery ✓

Explanation

The WOMAN trial (Lancet 2017) found that tranexamic acid reduced death due to bleeding when administered within 3 hours of delivery (RR 0.81, 95% CI 0.65–1.00), with a more pronounced reduction when given within 1 hour. There was no significant reduction in mortality after 3 hours, emphasising early administration. Tranexamic acid did not reduce hysterectomy or other surgical intervention rates in the overall trial. Based on this trial, tranexamic acid is now WHO-recommended as first-line treatment for PPH.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.