Evidence map›Paper›PMID 36933804›Full record

ArticleAmerican journal of obstetrics & gynecology MFM2023

An update to tranexamic acid trends during the peripartum period in the United States, 2019 to 2021.

Emma K Sterling, Ethan A Litman, Wayde D H Dazelle, Homa K Ahmadzia

Abstract readEvaluation Study
PubMed Full text at PMC Publisher
In one paragraph

Article in American journal of obstetrics & gynecology MFM, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Emma K SterlingSchool of Medicine and Health Sciences, George Washington University, Washington, DC (Ms Sterling and Mr Dazelle).
Ethan A LitmanDepartment of Obstetrics and Gynecology, George Washington University, Washington, DC (Dr Litman).
Wayde D H DazelleSchool of Medicine and Health Sciences, George Washington University, Washington, DC (Ms Sterling and Mr Dazelle).
Homa K AhmadziaDivision of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, George Washington University, Washington, DC (Dr Ahmadzia). Electronic address: hahmadzia@mfa.gwu.edu.

Funding

Prevention of postpartum hemorrhage: identifying pregnant women at risk and determining the safe and effective use of tranexamic acid using state-of-the-art pharmacokinetic/pharmacodynamics modelingK23HL141640 · NHLBI · GEORGE WASHINGTON UNIVERSITY · PI AHMADZIA, HOMA KHORRAMI · 2019 to 2022
$621k
NHLBI NIH HHS K23 HL141640
6 · The paper itself

Abstract

backgroundResults from the 2017 World Maternal Antifibrinolytic trial found that patients who received tranexamic acid during delivery had significantly lower rates of death and hysterectomy. Several months after the World Maternal Antifibrinolytic trial publication, American College of Obstetricians and Gynecologists endorsed the consideration of tranexamic acid usage when traditional uterotonics fail during postpartum hemorrhage. Since then, tranexamic acid usage has become more mainstream for the treatment of postpartum hemorrhage.

objectiveThis study aimed to evaluate tranexamic acid trends in obstetrics both temporally and geographically within the United States. Additional outcomes included patient demographics and perinatal outcomes. STUDY

designThis retrospective cohort study included 19 hospitals divided into East, Central, and West geographic regions within the Universal Health Services, Incorporated network. Rates of tranexamic acid use were compared from July 2019 through June 2021. Patient demographics and perinatal outcomes were analyzed for tranexamic acid recipients.

resultsDuring the two-year study period, 3.2% (1580/50,150) of patients received tranexamic acid during delivery. The western region of the United States demonstrated increased tranexamic acid use over the 2-year study period. Recipients of tranexamic acid were more likely to have a history of postpartum hemorrhage (P<.0001), chronic hypertension (P<.0001), preeclampsia (P<.0001), and/or diabetes (P=.004). Patients who received tranexamic acid did not have an increased likelihood of venous thromboembolism in comparison with those who did not receive tranexamic acid (8 [0.5%] vs 226 [0.5%]; P=.77). Of those who received tranexamic acid, 53.2% (840/1580) had an estimated blood loss <1000 mL.

conclusionNationally, a higher percentage of patients received tranexamic acid without a postpartum hemorrhage diagnosis compared with previous studies, and the western region of the United States had an overall increased use of tranexamic acid during delivery compared with previous years. There was no increased risk of venous thromboembolism in those who received tranexamic acid, regardless of postpartum hemorrhage diagnosis.

Indexed as

Antifibrinolytic AgentsPostpartum HemorrhageTranexamic AcidVenous ThromboembolismFemaleHumansPeripartum PeriodPregnancyRetrospective StudiesUnited StatesAntifibrinolytic AgentsTranexamic Acidperinatal outcomespostpartum hemorrhagetranexamic acidvenous thromboembolism

Identifiers

PMID36933804
PMCPMC10200754

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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.