SynthesisBMC pregnancy and childbirth2009
Anti-fibrinolytic agents in post partum haemorrhage: a systematic review.
Synthesis in BMC pregnancy and childbirth, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
20 citing papers in PubMed, 5 syntheses or guidelines pooled it, 119 citations in OpenAlex.
- Tranexamic acid for postpartum hemorrhage prevention in vaginal delivery: A meta-analysis.Medicine · 2020Pooled it
- Prophylactic management of postpartum haemorrhage in the third stage of labour: an overview of systematic reviews.Systematic reviews · 2018Pooled it
- Pooled it
- Clinical trials registries are underused in the pregnancy and childbirth literature: a systematic review of the top 20 journals.BMC research notes · 2016Pooled it
- Treatment for primary postpartum haemorrhage.The Cochrane database of systematic reviews · 2014Pooled it
- Study protocol. TRAAP - TRAnexamic Acid for Preventing postpartum hemorrhage after vaginal delivery: a multicenter randomized, double-blind, placebo-controlled trial.BMC pregnancy and childbirth · 2015Trial
- High-dose tranexamic acid reduces blood loss in postpartum haemorrhage.Critical care (London, England) · 2011Trial
- Trial
- Review
- Tranexamic Acid (TXA) for the Hemostatic Treatment of Post-Partum Hemorrhage (PPH): What Key Points Have We Learnt After All These Years?Journal of clinical medicine · 2023Article
- Reproductive Tract Bleeding in Adolescent and Young Adult Females with Inherited Bleeding Disorders: An Underappreciated Problem.Journal of pediatric and adolescent gynecology · 2022Review
- Synthesis of Isothiocyanates Using DMT/NMM/TsOMolecules (Basel, Switzerland) · 2021Article
- Coagulation abnormalities and bleeding in pregnancy: an anesthesiologist's perspective.Anesthesia and pain medicine · 2019Review
- Article
- Safety and efficacy of intravenous administration for tranexamic acid-induced emesis in dogs with accidental ingestion of foreign substances.The Journal of veterinary medical science · 2017Observational
- National and International Guidelines for Patient Blood Management in Obstetrics: A Qualitative Review.Anesthesia and analgesia · 2017Review
- Interventional Algorithms for the Control of Coagulopathic Bleeding in Surgical, Trauma, and Postpartum Settings: Recommendations From the Share Network Group.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis · 2016Article
- [Anesthesia in obstetrics: Tried and trusted methods, current standards and new challenges].Der Anaesthesist · 2016Article
- Postpartum acute renal failure: a multicenter study of risk factors in patients admitted to ICU.Annals of intensive care · 2014Article
- Tranexamic acid in obstetrics: Encouraging data in anemic parturients.Saudi journal of anaesthesia · 2013Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPost partum haemorrhage is a leading cause of maternal death worldwide. It also contributes to maternal morbidity as women may require a hysterectomy to control bleeding, or may require a blood transfusion, which can transmit viral infections. Anti-fibrinolytic agents have been proposed as a treatment for post partum haemorrhage. We conducted a systematic review to assess the effectiveness and safety of anti-fibrinolytic agents in post partum bleeding.
methodsAll randomised controlled trials of anti-fibrinolytic agents given for bleeding during the postpartum period were included in this review. We searched Medline, PubMed, EMBASE, Cochrane Central Register of Controlled trials, Web of Science, metaRegister of controlled trials, LILACS, Reproductive Health Library, African healthline, POPLINE, MedCarib, CINAHL, Clinicaltrials.gov and the reference lists of eligible trials. Two authors extracted data. Methodological quality was assessed by evaluating allocation concealment. The primary outcome was maternal mortality. Secondary outcomes were blood loss, blood transfusion, hysterectomy, mean haemoglobin concentration, thrombo-embolic events and other adverse effects.
resultsWe identified three randomised controlled trials involving 461 participants. The trials compared tranexamic acid with no treatment and reported blood loss after delivery. In all three trials, allocation concealment was either inadequate or unclear. The administration of tranexamic acid was associated with a reduction in blood loss of 92 millilitres (95%CI 76 to 109). The most frequently reported adverse effect of tranexamic acid was nausea, although the increase was easily compatible with the play of chance (RR 4.63, 95%CI 0.23 to 95.14).
conclusionTranexamic acid may reduce blood loss in post partum haemorrhage. However, the quality of the currently available evidence is poor. Adequately powered, high quality randomised controlled trials are needed.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.