The WOMAN trial (2017, Lancet) evaluating tranexamic acid in postpartum hemorrhage found that early administration (within 3 hours of delivery):

• A Reduced all-cause maternal mortality
• B Increased the rate of hysterectomy
• C Was only effective when given prophylactically before delivery
• D Reduced death due to bleeding without increased thromboembolic events ✓

Explanation

The WOMAN trial randomised 20,000 women with PPH to tranexamic acid vs placebo and showed that tranexamic acid significantly reduced death due to bleeding (RR 0.81) when given within 3 hours of delivery, with no increase in thromboembolic events. It did not reduce all-cause mortality overall, and it did not increase the hysterectomy rate. Prophylactic use before delivery was not its scope.

Reference: Williams Obstetrics, 26th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.