The WOMAN trial (World Maternal Antifibrinolytic Trial) evaluated tranexamic acid (TXA) in postpartum hemorrhage. Which statement correctly reflects its key finding?

• A TXA reduced the need for blood transfusion but had no mortality benefit
• B TXA was most effective when given by intramuscular route within 1 hour
• C TXA reduced hysterectomy rates in all patients regardless of timing
• D TXA given within 3 hours of PPH onset reduced death from bleeding without increasing thromboembolic events ✓

Explanation

The WOMAN trial (2017, Lancet) of 20,000 women showed TXA reduced death due to bleeding (RR 0.81) when given within 3 hours of PPH onset, with a time-sensitive effect (greatest benefit within 1 hour). Crucially, there was no increase in thromboembolic events. TXA did not significantly reduce all-cause mortality or hysterectomy rates. It is given IV (1 g), not IM. This led to WHO recommendations for early TXA use in PPH.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.