ArticleBMC pregnancy and childbirth2020
TRAAP2 - TRAnexamic Acid for Preventing postpartum hemorrhage after cesarean delivery: a multicenter randomized, doubleblind, placebo- controlled trial - a study protocol.
Article in BMC pregnancy and childbirth, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03431805 (TRAnexamic Acid for Preventing Postpartum Hemorrhage Following a Cesarean Delivery), which is not on this map. Cited by 10 papers, 2 of them syntheses that pooled it.
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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.
TRAnexamic Acid for Preventing Postpartum Hemorrhage Following a Cesarean Delivery :a Multicenter Randomised, Double Blind Placebo Controlled Trial (TRAAP2)
Who cites it
10 citing papers in PubMed, 2 syntheses or guidelines pooled it, 53 citations in OpenAlex.
- Tranexamic acid for preventing postpartum haemorrhage after vaginal birth.The Cochrane database of systematic reviews · 2025Pooled it
- Tranexamic acid for preventing postpartum haemorrhage after caesarean section.The Cochrane database of systematic reviews · 2024Pooled it
- Prophylactic tranexamic acid for the prevention of postpartum haemorrhage in women with placenta praevia: multicentre, double blind, randomised, placebo controlled, phase 3 trial.BMJ (Clinical research ed.) · 2026Trial
- Effect of Prophylactic Intraoperative Tranexamic Acid on Postpartum Blood Loss Following Cesarean Section at a Single Center.Medical science monitor : international medical journal of experimental and clinical research · 2025Trial
- Trial
- TRAPP- Protocol for Tranexamic Acid for the Prevention of Postpartum Hemorrhage in Pregnant Women With Placenta Previa.Maternal-fetal medicine (Wolters Kluwer Health, Inc.) · 2026Article
- Study protocol. TRAAPREVIA-TRAnexamic acid for preventing blood loss following a cesarean delivery in women with a placenta pREVIA or low-lying placenta: a multicenter randomized, double blind, placebo controlled trial.BMC pregnancy and childbirth · 2025Article
- Peripartum Haemorrhage, Diagnosis and Therapy. Guideline of the DGGG, OEGGG and SGGG (S2k, AWMF Registry No. 015-063, August 2022).Geburtshilfe und Frauenheilkunde · 2023Article
- The predictive role of second trimester uterocervical angle measurement in obstetric outcomes.Turkish journal of obstetrics and gynecology · 2022Article
- Tranexamic acid evidence and controversies: An illustrated review.Research and practice in thrombosis and haemostasis · 2021Review
Corrections and comments
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Authors and funding
4 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundAn antifibrinolytic agent that blocks lysine-binding sites on plasminogen molecules, tranexamic acid reduces bleeding-related mortality in women with postpartum hemorrhage (PPH), especially administered fairly soon after delivery. According to the randomized controlled trials thus far reported for PPH prevention after cesarean deliveries (n = 16), women who received tranexamic acid had significantly less postpartum blood loss and no increase in severe adverse effects. These were, however, primarily small single-center studies that had fundamental methodological flaws. Multicenter randomized controlled trials with adequate power are necessary to demonstrate its value persuasively before tranexamic acid goes into widespread use for the prevention of PPH after cesarean deliveries. METHODS/
designThis study will be a multicenter, double-blind, randomized controlled trial with two parallel groups including 4524 women with cesarean deliveries before or during labor, at a term ≥34 weeks, modeled on our previous study of tranexamic acid administered after vaginal deliveries. Treatment (either tranexamic acid 1 g or placebo) will be administered intravenously just after birth. All women will also receive a prophylactic uterotonic agent. The primary outcome will be the incidence of PPH, defined by a calculated estimated blood loss > 1000 mL or a red blood cell transfusion before day 2 postpartum. This study will have 80% power to show a 20% reduction in the incidence of PPH, from 15.0 to 12.0%. DISCUSSION: As an, inexpensive, easy to administer drug that can be add to the routine management of cesarean births in delivery rooms, tranexamic acid is a promising candidate for preventing PPH after these births. This large, adequately powered, multicenter randomized placebo-controlled trial seeks to determine if the benefits of the routine prophylactic use of tranexamic acid after cesarean delivery significantly outweigh its risks.
trial registrationClinicalTrials.gov NCT03431805 (February 12, 2018).
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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.