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TXA for postpartum hemorrhage prevention after cesarean

Loïc Sentilhes, MD, PHD, presented data on tranexamic acid (TXA) for the prevention of postpartum hemorrhage after cesarean delivery: the TRAAP2 trial, on Wednesday at SMFM's 2021 Virtual Annual Meeting.

This article is on based on information presented at the Society for Maternal-Fetal Medicine’s 2021 Virtual Annual Meeting, which is being held Jan. 25 to Jan. 30.

For more information and registration details, visit SMFM.org.

“As you all know, postpartum hemorrhage is a major cause of maternal death and severe maternal morbidity,” said Loïc Sentilhes, MD, of the Bordeaux University Hospital, France, presenting on behalf of the French Groupe de Recherche en Obstétrique et Gynécologie (GROG). “Today the prophylactic administration of a uterotonic is the only procedure that has been proven to reduce PPH after delivery and therefore is recommended by authorities for all women worldwide.”

TXA, which is an antifibrinolytic agent, reduces bleeding in elective surgery; and mortality in patients with extracranial and mild to moderate intracranial trauma, without increasing vascular occlusive events, he said. TXA has been demonstrated to reduce bleeding-related mortality in patients with PPH, especially when it is administered shortly after delivery, which suggests that it may prevent, rather than treat, coagulopathy after delivery.

In terms of vaginal delivery, Sentilhes said that they found no significant reduction in blood loss of at least 500 ml in women who received 1g of prophylactic TXA at delivery.