Topic
Obstetrics & critical care
Critical illness in pregnancy.
What the evidence shows
Tranexamic acid reduces death from bleeding in post-partum haemorrhage, with no excess thrombosis, across 20,060 women (WOMAN) — and it works best given early.
The contrast with gastrointestinal bleeding is instructive: the same drug, the same rationale, and no benefit at all (HALT-IT). The site of bleeding, not the antifibrinolytic, determines whether the strategy works.
Antifibrinolytics in obstetric haemorrhage
| Trial | Year | Therapy | Effect | Finding |
|---|---|---|---|---|
| WOMAN | 2017 | Tranexamic acid | Tranexamic acid reduced death from bleeding in post-partum haemorrhage, with no excess thrombosis |
Key references
Guidelines, standards and reviews for this topic.
- Tolcher MC, McKinney JR, Eppes CS, et al. Prone Positioning for Pregnant Women With Hypoxemia Due to Coronavirus Disease 2019 (COVID-19). Obstet Gynecol 2020 Aug;136(2):259-261. PMID 32516274
- ACOG Practice Bulletin No. 211: Critical Care in Pregnancy. Obstet Gynecol 2019 May;133(5):e303-e319. PMID 31022122
- Jeejeebhoy FM, Zelop CM, Lipman S, et al. Cardiac Arrest in Pregnancy: A Scientific Statement From the American Heart Association. Circulation 2015 Nov 3;132(18):1747-73. PMID 26443610