Tranexamic Acid for Postpartum Bleeding: A Systematic Review and Individual Patient Data Meta-Analysis of Randomized Controlled Trials

( Lancet . 2024;404(10463):1657–1667. DOI: 10.1016/S0140-6736(24)02102-0) The World Health Organization (WHO) recommends tranexamic acid (TXA) as part of obstetric hemorrhage (PPH) protocolized treatment as the WOMAN trial showed it decreases hemorrhage-related mortality compared to placebo when given following the diagnosis of PPH. This systematic review and individual patient data (IPD) meta-analysis aimed to assess the effectiveness of TXA in preventing life-threatening bleeding and thromboembolic events in women giving birth. The researchers searched the WHO International Clinical Trials Registry Platform for relevant randomized controlled trials from the inception of the database up to August 4, 2024. Eligible trials were those that were prospectively registered, placebo-controlled, involved more than 500 women, and had a low risk of bias in random sequence generation and allocation concealment. The study’s primary outcomes were the occurrence of life-threatening bleeding and thromboembolic events. IPD were requested from the trial investigators to conduct a more detailed analysis.