The WOMAN trial (2017) evaluated tranexamic acid (TXA) in postpartum haemorrhage. Which conclusion is MOST accurate based on its findings?

• A TXA reduced death from PPH when given within 3 hours of delivery ✓
• B TXA reduced hysterectomy rates significantly compared to placebo
• C TXA increased thromboembolic events in the treatment group
• D TXA had no mortality benefit regardless of timing of administration

Explanation

The WOMAN trial, a large RCT involving >20,000 women, found that early administration of TXA (within 3 hours of delivery) significantly reduced death due to bleeding (relative risk 0.81) without increasing thromboembolic events. There was no significant reduction in hysterectomy rates overall. Delayed treatment (> 3 hours) lost the mortality benefit, making early use critical.

Reference: Williams Obstetrics, 26th ed.

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Written and medically reviewed by the StethoPrep medical team.