The World Maternal Antifibrinolytic (WOMAN) trial evaluated tranexamic acid in PPH. Which was the KEY finding regarding death from bleeding?
- A TXA reduced death due to bleeding when given within 3 hours of delivery, with no benefit after 3 hours ✓
- B TXA significantly reduced all-cause mortality at 42 days
- C TXA increased thromboembolic events in PPH patients
- D TXA was only effective in high-income country settings
Correct answer: A. TXA reduced death due to bleeding when given within 3 hours of delivery, with no benefit after 3 hours
Explanation
The WOMAN trial (Lancet 2017) enrolled 20,060 women with PPH. The key finding was that tranexamic acid reduced death due to bleeding (1.5% vs 1.9%, RR 0.81) but only when given within 3 hours of delivery. After 3 hours, TXA did not reduce mortality. There was no increase in thromboembolic events. This established that early TXA administration (within 3 hours, and ideally within 1 hour) is critical for efficacy in PPH management.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.