Study of Tranexamic Acid Use and Outcomes in Women with Postpartum Hemorrhage After Cesarean Delivery

What this Trial Is About

Postpartum hemorrhage PPH is a leading cause of maternal death worldwide, especially in Thailand where it accounts for 20-30% of maternal fatalities. The World Maternal Antifibrinolytic Trial WOMAN Trial in 2017 showed that giving tranexamic acid TXA within three hours of bleeding onset reduces PPH-related deaths by 31%. Following this, the World Health Organization updated its guidelines to recommend TXA as part of standard care for all PPH cases. This study aims to analyze the recent increase in TXA use and its effects on outcomes during cesarean deliveries complicated by PPH. This observational study compares patients who received tranexamic acid after PPH with those who did not, focusing on those undergoing cesarean delivery. The study examines trends in TXA use over time following WHO recommendations and evaluates related obstetric and perinatal outcomes. The treatments are not assigned but observed retrospectively to assess the impact of TXA administration in real-world clinical practice. Participants medical records will be reviewed to collect data on TXA administration rates within 24 hours after delivery, amount of blood loss, blood transfusions, additional interventions, reoperations, causes of PPH, side effects, hospital stay length, and maternal mortality up to 30 days postpartum. The study updates previous findings by analyzing these outcomes in relation to the increased use of TXA after 2017. The total participation involves retrospective data collection from cesarean deliveries complicated by PPH.

Trends in the Administration of Tranexamic Acid for Postpartum Hemorrhage