A woman delivers a live term infant and 45 minutes later has an atonic uterus despite active management of the third stage. Oxytocin infusion has been running. The WOMAN trial showed that tranexamic acid given within 3 hours of PPH significantly reduced:
- A Hysterectomy rates due to PPH
- B Death from haemorrhage without increasing thromboembolic events ✓
- C The need for blood transfusion by 40%
- D Uterine atony by blocking prostaglandin synthesis
Correct answer: B. Death from haemorrhage without increasing thromboembolic events
Explanation
The WOMAN trial (2017) showed that tranexamic acid reduces death from PPH due to bleeding if given within 3 hours of delivery, without increasing thromboembolic events or organ failure. It did not significantly reduce hysterectomy rates or total transfusion requirements. Tranexamic acid is an antifibrinolytic (lysine analogue) that prevents plasminogen activation; it has no direct effect on prostaglandins.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.