Trial reportThe New England journal of medicine2023
Tranexamic Acid to Prevent Obstetrical Hemorrhage after Cesarean Delivery.
3 registry-linked trialsOpen access · greenAbstract readMulticenter StudyRandomized Controlled Trial
In one paragraph
Trial report in The New England journal of medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 43 papers, 7 of them syntheses that pooled it.
0numbers the graph read from it
0cells of the map it votes in
43citing papers in PubMed, 7 pooled it
11.7field-weighted citation impact, top 1% of its field
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.
Tranexamic Acid for the Prevention of Obstetrical Hemorrhage After Cesarean Delivery: A Randomized Controlled Trial
The Effect of Tranexamic Acid Rate of Administration on Blood Pressure in Healthy Pregnant Women Scheduled for Elective Cesarean Delivery Under Spinal Anesthesia - A Prospective, Randomized, Double-blind, Non-inferiority Trial.
NCT07078942 phase4not yet recruitingnot on this mapstarted 2025, after this paper: background citation
Effect of Preoperative Prophylactic Intravenous Tranexamic Acid on Perioperative Blood Loss in Pregnant Women Undergoing Cesarean Section : A Randomized Controlled Trial
Who cites it
43 citing papers in PubMed, 7 syntheses or guidelines pooled it, 109 citations in OpenAlex.
- Pooled it
- Meta-analysis: the prophylactic use of tranexamic acid to reduce blood loss during caesarean delivery.Irish journal of medical science · 2025Pooled it
- 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
- Tranexamic acid for postpartum bleeding: a systematic review and individual patient data meta-analysis of randomised controlled trials.Lancet (London, England) · 2024Pooled it
- Prophylactic tranexamic acid in Cesarean delivery: an updated meta-analysis with a trial sequential analysis.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2024Pooled it
- Tranexamic Acid in Patients Undergoing Liver Resection: An Updated Systematic Review and Meta-Analysis of Randomized Controlled Trials.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/HemostasisPooled it
- Predictors of Infection after Cesarean Delivery.American journal of perinatology · 2026Trial
- 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 tranexamic acid on blood loss in patients undergoing resection of large meningioma: a randomized clinical trial.Scientific reports · 2026Trial
- Uptake of orally administered tranexamic acid in women during active labor: A pilot intervention study on prophylactic treatment of postpartum hemorrhage.Acta obstetricia et gynecologica Scandinavica · 2025Trial
- Effects of tranexamic acid preconditioning on the incidence of postpartum haemorrhage in vaginal deliveries with identified risk factors in China: a prospective, randomized, open-label, blinded endpoint trial.Annals of medicine · 2024Trial
- Validation of Three Models for Prediction of Blood Transfusion during Cesarean Delivery Admission.American journal of perinatology · 2024Trial
- Prophylactic tranexamic acid for reducing intraoperative blood loss during cesarean section in women at high risk of postpartum hemorrhage: A double-blind placebo randomized controlled trial.Women's health (London, England)Trial
- Red Blood Cells and Tranexamic Acid in the Inhibition of Fibrinolysis.Seminars in thrombosis and hemostasis · 2026Review
- Article
- Prophylactic Use of Tranexamic Acid to Prevent Postpartum Hemorrhage in High-Risk Cesarean Deliveries: A Systematic Review and Meta-Analysis.Journal of clinical medicine · 2026Review
- Blood Product Use for Hemorrhage during Cesarean Delivery.American journal of perinatology · 2026Article
- Tranexamic acid use for the prevention of postpartum hemorrhage in high-income countries: a review of recent literature.AJOG global reports · 2026Article
- Perioperative Patient Blood Management: Evidence-Based Strategies for Surgeons and Anesthesiologists: A Narrative Review.Journal of clinical medicine · 2026Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
20 authors at 2 institutions in 2 countries.
Luis D PachecoFrom the University of Texas Medical Branch, Galveston (L.D.P., G.R.S., A.S.), the University of Texas Health Science Center at Houston, Children's Memorial Hermann Hospital, Houston (S.P.C.), and the University of Texas at Austin, Austin (G.A.M.) - all in Texas; the George Washington University Biostatistics Center, Washington, DC (R.G.C., S.J.W.); the University of Pennsylvania, Philadelphia (S.P.); the University of North Carolina at Chapel Hill, Chapel Hill (J.M.T.); the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD (M.L.); MetroHealth Medical Center, Case Western Reserve University, Cleveland (W.D., J.L.B.), and the Ohio State University, Columbus (K.R.) - both in Ohio; the University of Alabama at Birmingham, Birmingham (A.T.N.T.); Columbia University, New York (C.G.-B.); the University of Utah Health Sciences Center, Salt Lake City (T.D.M.); Brown University, Providence, RI (D.J.R.); Northwestern University, Chicago (W.A.G.); and the University of Pittsburgh, Pittsburgh (H.N.S.).
Rebecca G CliftonFrom the University of Texas Medical Branch, Galveston (L.D.P., G.R.S., A.S.), the University of Texas Health Science Center at Houston, Children's Memorial Hermann Hospital, Houston (S.P.C.), and the University of Texas at Austin, Austin (G.A.M.) - all in Texas; the George Washington University Biostatistics Center, Washington, DC (R.G.C., S.J.W.); the University of Pennsylvania, Philadelphia (S.P.); the University of North Carolina at Chapel Hill, Chapel Hill (J.M.T.); the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD (M.L.); MetroHealth Medical Center, Case Western Reserve University, Cleveland (W.D., J.L.B.), and the Ohio State University, Columbus (K.R.) - both in Ohio; the University of Alabama at Birmingham, Birmingham (A.T.N.T.); Columbia University, New York (C.G.-B.); the University of Utah Health Sciences Center, Salt Lake City (T.D.M.); Brown University, Providence, RI (D.J.R.); Northwestern University, Chicago (W.A.G.); and the University of Pittsburgh, Pittsburgh (H.N.S.).
George R SaadeFrom the University of Texas Medical Branch, Galveston (L.D.P., G.R.S., A.S.), the University of Texas Health Science Center at Houston, Children's Memorial Hermann Hospital, Houston (S.P.C.), and the University of Texas at Austin, Austin (G.A.M.) - all in Texas; the George Washington University Biostatistics Center, Washington, DC (R.G.C., S.J.W.); the University of Pennsylvania, Philadelphia (S.P.); the University of North Carolina at Chapel Hill, Chapel Hill (J.M.T.); the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD (M.L.); MetroHealth Medical Center, Case Western Reserve University, Cleveland (W.D., J.L.B.), and the Ohio State University, Columbus (K.R.) - both in Ohio; the University of Alabama at Birmingham, Birmingham (A.T.N.T.); Columbia University, New York (C.G.-B.); the University of Utah Health Sciences Center, Salt Lake City (T.D.M.); Brown University, Providence, RI (D.J.R.); Northwestern University, Chicago (W.A.G.); and the University of Pittsburgh, Pittsburgh (H.N.S.).
Steven J WeinerFrom the University of Texas Medical Branch, Galveston (L.D.P., G.R.S., A.S.), the University of Texas Health Science Center at Houston, Children's Memorial Hermann Hospital, Houston (S.P.C.), and the University of Texas at Austin, Austin (G.A.M.) - all in Texas; the George Washington University Biostatistics Center, Washington, DC (R.G.C., S.J.W.); the University of Pennsylvania, Philadelphia (S.P.); the University of North Carolina at Chapel Hill, Chapel Hill (J.M.T.); the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD (M.L.); MetroHealth Medical Center, Case Western Reserve University, Cleveland (W.D., J.L.B.), and the Ohio State University, Columbus (K.R.) - both in Ohio; the University of Alabama at Birmingham, Birmingham (A.T.N.T.); Columbia University, New York (C.G.-B.); the University of Utah Health Sciences Center, Salt Lake City (T.D.M.); Brown University, Providence, RI (D.J.R.); Northwestern University, Chicago (W.A.G.); and the University of Pittsburgh, Pittsburgh (H.N.S.).
Samuel ParryFrom the University of Texas Medical Branch, Galveston (L.D.P., G.R.S., A.S.), the University of Texas Health Science Center at Houston, Children's Memorial Hermann Hospital, Houston (S.P.C.), and the University of Texas at Austin, Austin (G.A.M.) - all in Texas; the George Washington University Biostatistics Center, Washington, DC (R.G.C., S.J.W.); the University of Pennsylvania, Philadelphia (S.P.); the University of North Carolina at Chapel Hill, Chapel Hill (J.M.T.); the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD (M.L.); MetroHealth Medical Center, Case Western Reserve University, Cleveland (W.D., J.L.B.), and the Ohio State University, Columbus (K.R.) - both in Ohio; the University of Alabama at Birmingham, Birmingham (A.T.N.T.); Columbia University, New York (C.G.-B.); the University of Utah Health Sciences Center, Salt Lake City (T.D.M.); Brown University, Providence, RI (D.J.R.); Northwestern University, Chicago (W.A.G.); and the University of Pittsburgh, Pittsburgh (H.N.S.).
John M ThorpFrom the University of Texas Medical Branch, Galveston (L.D.P., G.R.S., A.S.), the University of Texas Health Science Center at Houston, Children's Memorial Hermann Hospital, Houston (S.P.C.), and the University of Texas at Austin, Austin (G.A.M.) - all in Texas; the George Washington University Biostatistics Center, Washington, DC (R.G.C., S.J.W.); the University of Pennsylvania, Philadelphia (S.P.); the University of North Carolina at Chapel Hill, Chapel Hill (J.M.T.); the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD (M.L.); MetroHealth Medical Center, Case Western Reserve University, Cleveland (W.D., J.L.B.), and the Ohio State University, Columbus (K.R.) - both in Ohio; the University of Alabama at Birmingham, Birmingham (A.T.N.T.); Columbia University, New York (C.G.-B.); the University of Utah Health Sciences Center, Salt Lake City (T.D.M.); Brown University, Providence, RI (D.J.R.); Northwestern University, Chicago (W.A.G.); and the University of Pittsburgh, Pittsburgh (H.N.S.).
Monica LongoFrom the University of Texas Medical Branch, Galveston (L.D.P., G.R.S., A.S.), the University of Texas Health Science Center at Houston, Children's Memorial Hermann Hospital, Houston (S.P.C.), and the University of Texas at Austin, Austin (G.A.M.) - all in Texas; the George Washington University Biostatistics Center, Washington, DC (R.G.C., S.J.W.); the University of Pennsylvania, Philadelphia (S.P.); the University of North Carolina at Chapel Hill, Chapel Hill (J.M.T.); the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD (M.L.); MetroHealth Medical Center, Case Western Reserve University, Cleveland (W.D., J.L.B.), and the Ohio State University, Columbus (K.R.) - both in Ohio; the University of Alabama at Birmingham, Birmingham (A.T.N.T.); Columbia University, New York (C.G.-B.); the University of Utah Health Sciences Center, Salt Lake City (T.D.M.); Brown University, Providence, RI (D.J.R.); Northwestern University, Chicago (W.A.G.); and the University of Pittsburgh, Pittsburgh (H.N.S.).
Ashley SalazarFrom the University of Texas Medical Branch, Galveston (L.D.P., G.R.S., A.S.), the University of Texas Health Science Center at Houston, Children's Memorial Hermann Hospital, Houston (S.P.C.), and the University of Texas at Austin, Austin (G.A.M.) - all in Texas; the George Washington University Biostatistics Center, Washington, DC (R.G.C., S.J.W.); the University of Pennsylvania, Philadelphia (S.P.); the University of North Carolina at Chapel Hill, Chapel Hill (J.M.T.); the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD (M.L.); MetroHealth Medical Center, Case Western Reserve University, Cleveland (W.D., J.L.B.), and the Ohio State University, Columbus (K.R.) - both in Ohio; the University of Alabama at Birmingham, Birmingham (A.T.N.T.); Columbia University, New York (C.G.-B.); the University of Utah Health Sciences Center, Salt Lake City (T.D.M.); Brown University, Providence, RI (D.J.R.); Northwestern University, Chicago (W.A.G.); and the University of Pittsburgh, Pittsburgh (H.N.S.).
Wendy DaltonFrom the University of Texas Medical Branch, Galveston (L.D.P., G.R.S., A.S.), the University of Texas Health Science Center at Houston, Children's Memorial Hermann Hospital, Houston (S.P.C.), and the University of Texas at Austin, Austin (G.A.M.) - all in Texas; the George Washington University Biostatistics Center, Washington, DC (R.G.C., S.J.W.); the University of Pennsylvania, Philadelphia (S.P.); the University of North Carolina at Chapel Hill, Chapel Hill (J.M.T.); the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD (M.L.); MetroHealth Medical Center, Case Western Reserve University, Cleveland (W.D., J.L.B.), and the Ohio State University, Columbus (K.R.) - both in Ohio; the University of Alabama at Birmingham, Birmingham (A.T.N.T.); Columbia University, New York (C.G.-B.); the University of Utah Health Sciences Center, Salt Lake City (T.D.M.); Brown University, Providence, RI (D.J.R.); Northwestern University, Chicago (W.A.G.); and the University of Pittsburgh, Pittsburgh (H.N.S.).
Alan T N TitaFrom the University of Texas Medical Branch, Galveston (L.D.P., G.R.S., A.S.), the University of Texas Health Science Center at Houston, Children's Memorial Hermann Hospital, Houston (S.P.C.), and the University of Texas at Austin, Austin (G.A.M.) - all in Texas; the George Washington University Biostatistics Center, Washington, DC (R.G.C., S.J.W.); the University of Pennsylvania, Philadelphia (S.P.); the University of North Carolina at Chapel Hill, Chapel Hill (J.M.T.); the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD (M.L.); MetroHealth Medical Center, Case Western Reserve University, Cleveland (W.D., J.L.B.), and the Ohio State University, Columbus (K.R.) - both in Ohio; the University of Alabama at Birmingham, Birmingham (A.T.N.T.); Columbia University, New York (C.G.-B.); the University of Utah Health Sciences Center, Salt Lake City (T.D.M.); Brown University, Providence, RI (D.J.R.); Northwestern University, Chicago (W.A.G.); and the University of Pittsburgh, Pittsburgh (H.N.S.).ORCID 0000-0002-7244-9056
Cynthia Gyamfi-BannermanFrom the University of Texas Medical Branch, Galveston (L.D.P., G.R.S., A.S.), the University of Texas Health Science Center at Houston, Children's Memorial Hermann Hospital, Houston (S.P.C.), and the University of Texas at Austin, Austin (G.A.M.) - all in Texas; the George Washington University Biostatistics Center, Washington, DC (R.G.C., S.J.W.); the University of Pennsylvania, Philadelphia (S.P.); the University of North Carolina at Chapel Hill, Chapel Hill (J.M.T.); the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD (M.L.); MetroHealth Medical Center, Case Western Reserve University, Cleveland (W.D., J.L.B.), and the Ohio State University, Columbus (K.R.) - both in Ohio; the University of Alabama at Birmingham, Birmingham (A.T.N.T.); Columbia University, New York (C.G.-B.); the University of Utah Health Sciences Center, Salt Lake City (T.D.M.); Brown University, Providence, RI (D.J.R.); Northwestern University, Chicago (W.A.G.); and the University of Pittsburgh, Pittsburgh (H.N.S.).
Suneet P ChauhanFrom the University of Texas Medical Branch, Galveston (L.D.P., G.R.S., A.S.), the University of Texas Health Science Center at Houston, Children's Memorial Hermann Hospital, Houston (S.P.C.), and the University of Texas at Austin, Austin (G.A.M.) - all in Texas; the George Washington University Biostatistics Center, Washington, DC (R.G.C., S.J.W.); the University of Pennsylvania, Philadelphia (S.P.); the University of North Carolina at Chapel Hill, Chapel Hill (J.M.T.); the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD (M.L.); MetroHealth Medical Center, Case Western Reserve University, Cleveland (W.D., J.L.B.), and the Ohio State University, Columbus (K.R.) - both in Ohio; the University of Alabama at Birmingham, Birmingham (A.T.N.T.); Columbia University, New York (C.G.-B.); the University of Utah Health Sciences Center, Salt Lake City (T.D.M.); Brown University, Providence, RI (D.J.R.); Northwestern University, Chicago (W.A.G.); and the University of Pittsburgh, Pittsburgh (H.N.S.).
Torri D MetzFrom the University of Texas Medical Branch, Galveston (L.D.P., G.R.S., A.S.), the University of Texas Health Science Center at Houston, Children's Memorial Hermann Hospital, Houston (S.P.C.), and the University of Texas at Austin, Austin (G.A.M.) - all in Texas; the George Washington University Biostatistics Center, Washington, DC (R.G.C., S.J.W.); the University of Pennsylvania, Philadelphia (S.P.); the University of North Carolina at Chapel Hill, Chapel Hill (J.M.T.); the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD (M.L.); MetroHealth Medical Center, Case Western Reserve University, Cleveland (W.D., J.L.B.), and the Ohio State University, Columbus (K.R.) - both in Ohio; the University of Alabama at Birmingham, Birmingham (A.T.N.T.); Columbia University, New York (C.G.-B.); the University of Utah Health Sciences Center, Salt Lake City (T.D.M.); Brown University, Providence, RI (D.J.R.); Northwestern University, Chicago (W.A.G.); and the University of Pittsburgh, Pittsburgh (H.N.S.).
Kara RoodFrom the University of Texas Medical Branch, Galveston (L.D.P., G.R.S., A.S.), the University of Texas Health Science Center at Houston, Children's Memorial Hermann Hospital, Houston (S.P.C.), and the University of Texas at Austin, Austin (G.A.M.) - all in Texas; the George Washington University Biostatistics Center, Washington, DC (R.G.C., S.J.W.); the University of Pennsylvania, Philadelphia (S.P.); the University of North Carolina at Chapel Hill, Chapel Hill (J.M.T.); the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD (M.L.); MetroHealth Medical Center, Case Western Reserve University, Cleveland (W.D., J.L.B.), and the Ohio State University, Columbus (K.R.) - both in Ohio; the University of Alabama at Birmingham, Birmingham (A.T.N.T.); Columbia University, New York (C.G.-B.); the University of Utah Health Sciences Center, Salt Lake City (T.D.M.); Brown University, Providence, RI (D.J.R.); Northwestern University, Chicago (W.A.G.); and the University of Pittsburgh, Pittsburgh (H.N.S.).
Dwight J RouseFrom the University of Texas Medical Branch, Galveston (L.D.P., G.R.S., A.S.), the University of Texas Health Science Center at Houston, Children's Memorial Hermann Hospital, Houston (S.P.C.), and the University of Texas at Austin, Austin (G.A.M.) - all in Texas; the George Washington University Biostatistics Center, Washington, DC (R.G.C., S.J.W.); the University of Pennsylvania, Philadelphia (S.P.); the University of North Carolina at Chapel Hill, Chapel Hill (J.M.T.); the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD (M.L.); MetroHealth Medical Center, Case Western Reserve University, Cleveland (W.D., J.L.B.), and the Ohio State University, Columbus (K.R.) - both in Ohio; the University of Alabama at Birmingham, Birmingham (A.T.N.T.); Columbia University, New York (C.G.-B.); the University of Utah Health Sciences Center, Salt Lake City (T.D.M.); Brown University, Providence, RI (D.J.R.); Northwestern University, Chicago (W.A.G.); and the University of Pittsburgh, Pittsburgh (H.N.S.).
Jennifer L BailitFrom the University of Texas Medical Branch, Galveston (L.D.P., G.R.S., A.S.), the University of Texas Health Science Center at Houston, Children's Memorial Hermann Hospital, Houston (S.P.C.), and the University of Texas at Austin, Austin (G.A.M.) - all in Texas; the George Washington University Biostatistics Center, Washington, DC (R.G.C., S.J.W.); the University of Pennsylvania, Philadelphia (S.P.); the University of North Carolina at Chapel Hill, Chapel Hill (J.M.T.); the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD (M.L.); MetroHealth Medical Center, Case Western Reserve University, Cleveland (W.D., J.L.B.), and the Ohio State University, Columbus (K.R.) - both in Ohio; the University of Alabama at Birmingham, Birmingham (A.T.N.T.); Columbia University, New York (C.G.-B.); the University of Utah Health Sciences Center, Salt Lake City (T.D.M.); Brown University, Providence, RI (D.J.R.); Northwestern University, Chicago (W.A.G.); and the University of Pittsburgh, Pittsburgh (H.N.S.).
William A GrobmanFrom the University of Texas Medical Branch, Galveston (L.D.P., G.R.S., A.S.), the University of Texas Health Science Center at Houston, Children's Memorial Hermann Hospital, Houston (S.P.C.), and the University of Texas at Austin, Austin (G.A.M.) - all in Texas; the George Washington University Biostatistics Center, Washington, DC (R.G.C., S.J.W.); the University of Pennsylvania, Philadelphia (S.P.); the University of North Carolina at Chapel Hill, Chapel Hill (J.M.T.); the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD (M.L.); MetroHealth Medical Center, Case Western Reserve University, Cleveland (W.D., J.L.B.), and the Ohio State University, Columbus (K.R.) - both in Ohio; the University of Alabama at Birmingham, Birmingham (A.T.N.T.); Columbia University, New York (C.G.-B.); the University of Utah Health Sciences Center, Salt Lake City (T.D.M.); Brown University, Providence, RI (D.J.R.); Northwestern University, Chicago (W.A.G.); and the University of Pittsburgh, Pittsburgh (H.N.S.).
Hyagriv N SimhanFrom the University of Texas Medical Branch, Galveston (L.D.P., G.R.S., A.S.), the University of Texas Health Science Center at Houston, Children's Memorial Hermann Hospital, Houston (S.P.C.), and the University of Texas at Austin, Austin (G.A.M.) - all in Texas; the George Washington University Biostatistics Center, Washington, DC (R.G.C., S.J.W.); the University of Pennsylvania, Philadelphia (S.P.); the University of North Carolina at Chapel Hill, Chapel Hill (J.M.T.); the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD (M.L.); MetroHealth Medical Center, Case Western Reserve University, Cleveland (W.D., J.L.B.), and the Ohio State University, Columbus (K.R.) - both in Ohio; the University of Alabama at Birmingham, Birmingham (A.T.N.T.); Columbia University, New York (C.G.-B.); the University of Utah Health Sciences Center, Salt Lake City (T.D.M.); Brown University, Providence, RI (D.J.R.); Northwestern University, Chicago (W.A.G.); and the University of Pittsburgh, Pittsburgh (H.N.S.).
George A MaconesFrom the University of Texas Medical Branch, Galveston (L.D.P., G.R.S., A.S.), the University of Texas Health Science Center at Houston, Children's Memorial Hermann Hospital, Houston (S.P.C.), and the University of Texas at Austin, Austin (G.A.M.) - all in Texas; the George Washington University Biostatistics Center, Washington, DC (R.G.C., S.J.W.); the University of Pennsylvania, Philadelphia (S.P.); the University of North Carolina at Chapel Hill, Chapel Hill (J.M.T.); the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD (M.L.); MetroHealth Medical Center, Case Western Reserve University, Cleveland (W.D., J.L.B.), and the Ohio State University, Columbus (K.R.) - both in Ohio; the University of Alabama at Birmingham, Birmingham (A.T.N.T.); Columbia University, New York (C.G.-B.); the University of Utah Health Sciences Center, Salt Lake City (T.D.M.); Brown University, Providence, RI (D.J.R.); Northwestern University, Chicago (W.A.G.); and the University of Pittsburgh, Pittsburgh (H.N.S.).
Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal–Fetal Medicine Units Network
Memorial Hermann · USUniversity of North Carolina at Chapel Hill · US
Funding
SARS-CoV-2 Vaccine Pregnancy RegistryU24HD036801 · NICHD · GEORGE WASHINGTON UNIVERSITY · PI Rebecca Gersnoviez Clifton · 2021 to 2026
$39.2MUtah Center for Clinical and Translational ScienceUL1TR002538 · NCATS · UNIVERSITY OF UTAH · PI HESS, RACHEL, MAJERSIK, JENNIFER JUHL · 2018 to 2022
$26.0MCTSA UM1 Program at University of UtahUM1TR004409 · NCATS · UTAH STATE HIGHER EDUCATION SYSTEM--UNIVERSITY OF UTAH · PI RACHEL HESS, Jennifer Juhl Majersik · 2023 to 2026
$21.9MNICHD Maternal Fetal Medicine Units NetworkU10HD034208 · NICHD · UNIVERSITY OF UTAH · PI VARNER, MICHAEL W. · 1996 to 2015
$16.6MNICHD Maternal Fetal Medicine Units NetworkU10HD040500 · NICHD · WOMEN AND INFANTS HOSPITAL-RHODE ISLAND · PI ROUSE, DWIGHT J · 2001 to 2015
$7.5MMaternal-Fetal Medicine Units (MFMU) NetworkUG1HD040485 · NICHD · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI Noelia Milena Modad Zork · 2016 to 2026
$3.6MNICHD Maternal Fetal Medicine Units NetworkUG1HD087192 · NICHD · UNIVERSITY OF PENNSYLVANIA · PI Lorraine Dugoff · 2016 to 2026
$3.6MNICHD Maternal-Fetal Medicine Units (MFMU) NetworkUG1HD040544 · NICHD · CASE WESTERN RESERVE UNIVERSITY · PI Kelly S Gibson, Angela C. Ranzini · 2016 to 2026
$3.5MMaternal-Fetal Medicine Units Network -- The Northwestern Study CenterUG1HD040512 · NICHD · NORTHWESTERN UNIVERSITY AT CHICAGO · PI Lynn M Yee · 2016 to 2026
$3.4MNICHD Maternal-Fetal Medicine Units (MFMU) NetworkUG1HD040500 · NICHD · WOMEN AND INFANTS HOSPITAL-RHODE ISLAND · PI DWIGHT J ROUSE · 2016 to 2026
$3.4MUofU Maternal-Fetal Medicine Units (MFMU) Network: Clinical CentersUG1HD034208 · NICHD · UTAH STATE HIGHER EDUCATION SYSTEM--UNIVERSITY OF UTAH · PI Torri D Metz · 2016 to 2026
$3.4MNICHD Maternal Fetal Medicine Units NetworkUG1HD027915 · NICHD · OHIO STATE UNIVERSITY · PI Maged Costantine · 2016 to 2026
$3.3MNCATS NIH HHS UL1 TR002538NCATS NIH HHS UM1 TR004409NICHD NIH HHS U10 HD034208NICHD NIH HHS U10 HD040500NICHD NIH HHS U24 HD036801NICHD NIH HHS UG1 HD027869NICHD NIH HHS UG1 HD027915NICHD NIH HHS UG1 HD034208NICHD NIH HHS UG1 HD040485NICHD NIH HHS UG1 HD040500NICHD NIH HHS UG1 HD040512NICHD NIH HHS UG1 HD040544NICHD NIH HHS UG1 HD040545NICHD NIH HHS UG1 HD040560NICHD NIH HHS UG1 HD053097NICHD NIH HHS UG1 HD087192NICHD NIH HHS UG1 HD087230
Abstract
backgroundProphylactic use of tranexamic acid at the time of cesarean delivery has been shown to decrease the calculated blood loss, but the effect on the need for blood transfusions is unclear.
methodsWe randomly assigned patients undergoing cesarean delivery at 31 U.S. hospitals to receive either tranexamic acid or placebo after umbilical-cord clamping. The primary outcome was a composite of maternal death or blood transfusion by hospital discharge or 7 days post partum, whichever came first. Key secondary outcomes were estimated intraoperative blood loss of more than 1 liter (prespecified as a major secondary outcome), interventions for bleeding and related complications, the preoperative-to-postoperative change in the hemoglobin level, and postpartum infectious complications. Adverse events were assessed.
resultsA total of 11,000 participants underwent randomization (5529 to the tranexamic acid group and 5471 to the placebo group); scheduled cesarean delivery accounted for 50.1% and 49.2% of the deliveries in the respective groups. A primary-outcome event occurred in 201 of 5525 participants (3.6%) in the tranexamic acid group and in 233 of 5470 (4.3%) in the placebo group (adjusted relative risk, 0.89; 95.26% confidence interval [CI], 0.74 to 1.07; P = 0.19). Estimated intraoperative blood loss of more than 1 liter occurred in 7.3% of the participants in the tranexamic acid group and in 8.0% of those in the placebo group (relative risk, 0.91; 95% CI, 0.79 to 1.05). Interventions for bleeding complications occurred in 16.1% of the participants in the tranexamic acid group and in 18.0% of those in the placebo group (relative risk, 0.90; 95% CI, 0.82 to 0.97); the change in the hemoglobin level was -1.8 g per deciliter and -1.9 g per deciliter, respectively (mean difference, -0.1 g per deciliter; 95% CI, -0.2 to -0.1); and postpartum infectious complications occurred in 3.2% and 2.5% of the participants, respectively (relative risk, 1.28; 95% CI, 1.02 to 1.61). The frequencies of thromboembolic events and other adverse events were similar in the two groups.
conclusionsProphylactic use of tranexamic acid during cesarean delivery did not lead to a significantly lower risk of a composite outcome of maternal death or blood transfusion than placebo. (Funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development; ClinicalTrials.gov number, NCT03364491.).
Indexed as
Antifibrinolytic AgentsCesarean SectionPostpartum HemorrhageTranexamic AcidBlood Loss, SurgicalBlood TransfusionChemopreventionChildFemaleHemoglobinsHumansMaternal DeathPregnancyAntifibrinolytic AgentsHemoglobinsTranexamic Acid
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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.