Tranexamic acid for the treatment of post-partum haemorrhage
Tranexamic acid for the prevention of post-partum haemorrhage
Tranexamic acid and heavy menstrual bleeding
Tranexamic acid and surgical bleeding
Tranexamic acid and traumatic bleeding
Table: Established indications for tranexamic acid
Future research priorities
- 1 WOMAN Trial Collaborators. Effect of early tranexamic acid administration on mortality, hysterectomy, and other morbidities in women with post-partum haemorrhage (WOMAN): an international, randomised, double-blind, placebo-controlled trial. Lancet 2017; 389: 2105–16.
- 2 World Health Organization. Updated WHO Recommendation on Tranexamic Acid for the Treatment of Postpartum Haemorrhage. 2017;: 1–5.
- 3 ACOG Expands Recommendations to Treat Postpartum Hemorrhage | ACOG. https://www.acog.org/news/news-releases/2017/09/acog-expands-recommendations-to-treat-postpartum-hemorrhage (accessed May 24, 2022).
- 4 Hellgren M. Hemostasis during normal pregnancy and puerperium. Semin Thromb Hemost 2003; 29: 125–30.
- 5 Kruithof EK, Tran-Thang C, Gudinchet A, et al. Fibrinolysis in pregnancy: a study of plasminogen activator inhibitors. Blood 1987; 69: 460–6.
- 6 Knight M, Bunch K, Tuffnell D, et al. Saving Lives, Improving Mothers’ Care Maternal, Newborn and Infant Clinical Outcome Review Programme. 2021. www.hqip.org.uk/national-programmes. (accessed May 24, 2022).
- 7 James AH. Venous thromboembolism in pregnancy. Arterioscler Thromb Vasc Biol 2009; 29: 326–31.
- 8 Ker K, Roberts I, Chaudhri R, et al. Tranexamic acid for the prevention of postpartum bleeding in women with anaemia: study protocol for an international, randomised, double-blind, placebo-controlled trial. Trials 2018; 19: 712.
- 9 Nair M, Choudhury MK, Choudhury SS, et al. Association between maternal anaemia and pregnancy outcomes: A cohort study in Assam, India. BMJ Glob Heal 2016; 1: e000026.
- 10 Weiskopf RB, Viele MK, Feiner J, et al. Human cardiovascular and metabolic response to acute, severe isovolemic anemia. JAMA 1998; 279: 217–21.
- 11 Whittaker SRF, Winton FR. The apparent viscosity of blood flowing in the isolated hindlimb of the dog, and its variation with corpuscular concentration. J Physiol 1933; 78: 339–69.
- 12 Guyton AC, Richardson TQ. Effect of hematocrit on venous return. Circ Res 1961; 9: 157–64.
- 13 Wohner N, Sótonyi P, MacHovich R, et al. Lytic resistance of fibrin containing red blood cells. Arterioscler Thromb Vasc Biol 2011; 31: 2306–13.
- 14 Nair M, Chhabra S, Choudhury SS, et al. Relationship between anaemia, coagulation parameters during pregnancy and postpartum haemorrhage at childbirth: a prospective cohort study. 2021; 11: e050815.
- 15 Sentilhes L, Winer N, Azria E, et al. Tranexamic Acid for the Prevention of Blood Loss after Vaginal Delivery. N Engl J Med 2018; 379: 731–42.
- 16 Sentilhes L, Sénat M V., Le Lous M, et al. Tranexamic Acid for the Prevention of Blood Loss after Cesarean Delivery. N Engl J Med 2021; 384: 1623–34.
- 17 Pacheco LD. Tranexamic Acid for the Prevention of Obstetrical Hemorrhage After Cesarean Delivery: A Randomized Controlled Trial. Am J Obstet Gynecol 2022; 226: S779–80.
- 18 Young MF. Maternal anaemia and risk of mortality: a call for action. Lancet Glob. Heal. 2018; 6: e479–80.
- 19 Sunuwar DR, Singh DR, Chaudhary NK, Pradhan PMS, Rai P, Tiwari K. Prevalence and factors associated with anemia among women of reproductive age in seven South and Southeast Asian countries: Evidence from nationally representative surveys. PLoS One 2020; 15: e0236449.
- 20 Stevens GA, Finucane MM, De-Regil LM, et al. Global, regional, and national trends in haemoglobin concentration and prevalence of total and severe anaemia in children and pregnant and non-pregnant women for 1995-2011: A systematic analysis of population-representative data. Lancet Glob Heal 2013; 1: e16–25.
- 21 Haas JD, Brownlie IV T. Iron deficiency and reduced work capacity: A critical review of the research to determine a causal relationship. In: Journal of Nutrition. American Institute of Nutrition, 2001. DOI:10.1093/jn/131.2.676s.
- 22 Rahman MM, Abe SK, Rahman MS, et al. Maternal anemia and risk of adverse birth and health outcomes in low- and middle-income countries: Systematic review and meta-analysis. Am J Clin Nutr 2016; 103: 495–504.
- 23 Young MF, Oaks BM, Tandon S, Martorell R, Dewey KG, Wendt AS. Maternal hemoglobin concentrations across pregnancy and maternal and child health: a systematic review and meta-analysis. Ann. N. Y. Acad. Sci. 2019; 1450: 47.
- 24 Daru MBBS J, Zamora J, Thangaratinam S, et al. Risk of maternal mortality in women with severe anaemia during pregnancy and post partum: a multilevel analysis. Lancet Glob Heal 2018; 6: e548–54.
- 25 Ofojekwu M-JN, Nnanna OU, Okolie CE, Odewumi LA, Isiguzoro IOU, Lugos MD. Hemoglobin and Serum Iron Concentrations in Menstruating Nulliparous Women in Jos, Nigeria. Lab Med 2013; 44: 121–4.
- 26 Barr F, Brabin L, Agbaje S, Buseri F, Ikimalo J, Briggs N. Reducing iron deficiency anaemia due to heavy menstrual blood loss in Nigerian rural adolescents. Public Health Nutr 1998; 1: 249–57.
- 27 Hallberg L, Högdahl A ‐M, Nilsson L, Rybo G. Menstrual Blood Loss and Iron Deficiency. Acta Med Scand 1966; 180: 639–50.
- 28 Schoep ME, Nieboer TE, van der Zanden M, Braat DDM, Nap AW. The impact of menstrual symptoms on everyday life: a survey among 42,879 women. Am J Obstet Gynecol 2019; 220: 569.e1-569.e7.
- 29 WHO. Global anaemia reduction efforts among women of reproductive age: impact, achievement of targets and the way forward for optimizing efforts. 2020 https://www.who.int/publications/i/item/9789240012202 (accessed Jan 18, 2021).
- 30 Critchley HOD, Munro MG, Shakur-Still H, Roberts I. Menstruation should not be overlooked in control of anaemia. Lancet. 2021; 397: 26.
- 31 Gleeson N c., Buggy F, Sheppard BL, Bonnar J. The effect of tranexamic acid on measured menstrual loss and endometrial fibrinolytic enzymes in dysfunctional uterine bleeding. Acta Obstet Gynecol Scand 1994; 73: 274–7.
- 32 Bryant-Smith AC, Lethaby A, Farquhar C, Hickey M. Antifibrinolytics for heavy menstrual bleeding. Cochrane Database Syst. Rev. 2018; 2018. DOI:10.1002/14651858.CD000249.pub2.
- 33 Ker K, Edwards P, Perel P, Shakur H, Roberts I. Effect of tranexamic acid on surgical bleeding: systematic review and cumulative meta-analysis. BMJ 2012; 344: e3054.
- 34 Ker K, Prieto-Merino D, Roberts I. Systematic review, meta-analysis and meta-regression of the effect of tranexamic acid on surgical blood loss. Br. J. Surg. 2013. DOI:10.1002/bjs.9193.
- 35 Taeuber I, Weibel S, Herrmann E, et al. Association of Intravenous Tranexamic Acid With Thromboembolic Events and Mortality: A Systematic Review, Meta-analysis, and Meta-regression. JAMA Surg 2021; 156: e210884–e210884.
- 36 Murao S, Nakata H, Roberts I, Yamakawa K. Effect of tranexamic acid on thrombotic events and seizures in bleeding patients: a systematic review and meta-analysis. Crit Care 2021; 25: 1–11.
- 37 Devereaux PJ, Marcucci M, Painter TW, et al. Tranexamic Acid in Patients Undergoing Noncardiac Surgery. N Engl J Med 2022; published online April 2. DOI:10.1056/NEJMoa2201171.
- 38 Guerriero C, Cairns J, Jayaraman S, Roberts I, Perel P, Shakur H. Giving tranexamic acid to reduce surgical bleeding in sub-Saharan Africa: an economic evaluation. Cost Eff Resour Alloc 2010 81 2010; 8: 1–11.
- 39 CRASH-2 trial collaborators, Shakur H, Roberts I, et al. Effects of tranexamic acid on death, vascular occlusive events, and blood transfusion in trauma patients with significant haemorrhage (CRASH-2): a randomised, placebo-controlled trial. Lancet (London, England) 2010; 376: 23–32.
- 40 CRASH-3 Collaborators. Effects of tranexamic acid on death, disability, vascular occlusive events and other morbidities in patients with acute traumatic brain injury (CRASH-3): a randomised, placebo-controlled trial. Lancet 2019; 394: 1713–23.
- 41 Roberts I, Shakur-Still H. Tranexamic acid for trauma in the USA: is prejudice a barrier to saving lives? Lancet 2022; 399: 1675–7.
- 42 Wallace M, Gillispie-Bell V, Cruz K, Davis K, Vilda D. Homicide During Pregnancy and the Postpartum Period in the United States, 2018-2019. Obstet Gynecol 2021; 138: 762–9.
- 43 Nutbeam T, Roberts I, Weekes L, Shakur-Still H, Brenner A, Ageron F-X. Use of tranexamic acid in major trauma: a sex-disaggragated analysis of the Clinical Randomisation of an Antifibrinolytic in Significant Haemorrhage (CRASH-2 and CRASH-3) trials and UK trauma registry (Trauma and Audit Research Network) data. Br J Anaesth 2022; published online May. DOI:10.1016/J.BJA.2022.03.032.
- 44. Ker K, Kiriya J, Perel P, Edwards P, Shakur H, Roberts I. Avoidable mortality from giving tranexamic acid to bleeding trauma patients: an estimation based on WHO mortality data, a systematic literature review and data from the CRASH-2 trial. BMC Emerg Med. 2012;12:3. Epub 2012/03/03.
Publication stageIn Press Accepted Manuscript
User LicenseCreative Commons Attribution (CC BY 4.0) |
- Read, print & download
- Redistribute or republish the final article
- Text & data mine
- Translate the article
- Reuse portions or extracts from the article in other works
- Sell or re-use for commercial purposes
Elsevier's open access license policy