Tranexamic Acid to Prevent Obstetrical Hemorrhage after Cesarean Delivery

This multicenter, randomized, placebo controlled trial evaluated the efficacy of prophylactic tranexamic acid in reducing maternal death or blood transfusion risk after cesarean delivery. Among 11,000 participants, tranexamic acid did not significantly lower the primary composite outcome (3.6% vs. 4.3% with placebo; adjusted relative risk 0.89, 95% CI 0.74–1.07). While interventions for bleeding complications were slightly reduced (16.1% vs. 18.0%), thromboembolic risks were similar. The study concluded that tranexamic acid did not meaningfully decrease transfusion needs or mortality, challenging its routine use for hemorrhage prevention in cesarean deliveries.

This multicenter, randomized, placebo controlled trial evaluated the efficacy of prophylactic tranexamic acid in reducing maternal death or blood transfusion risk after cesarean delivery. Among 11,000 participants, tranexamic acid did not significantly lower the primary composite outcome (3.6% vs. 4.3% with placebo; adjusted relative risk 0.89, 95% CI 0.74–1.07). While interventions for bleeding complications were slightly reduced (16.1% vs. 18.0%), thromboembolic risks were similar. The study concluded that tranexamic acid did not meaningfully decrease transfusion needs or mortality, challenging its routine use for hemorrhage prevention in cesarean deliveries.