Evidence map›Paper›PMID 37601311›Full record

ArticleGates open research2023

Tranexamic acid for the prevention of postpartum bleeding: Protocol for a systematic review and individual patient data meta-analysis.

Anti-fibrinolytics Trialists Collaborators – Obstetric Trialists Group, Katharine Ker, Haleema Shakur-Still, Loïc Sentilhes, Luis D Pacheco, George Saade, Catherine Deneux-Tharaux, Amy Brenner, Raoul Mansukhani, François-Xavier Ageron and 4 more

Abstract read
In one paragraph

Article in Gates open research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 2 pooled it
–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

4 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Review
  4. Article
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

14 authors.

Anti-fibrinolytics Trialists Collaborators – Obstetric Trialists Group
Katharine KerCTU Global Health Trials Group, London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK.ORCID https://orcid.org/0000-0002-1514-5005
Haleema Shakur-StillCTU Global Health Trials Group, London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK.ORCID https://orcid.org/0000-0002-6511-109X
Loïc SentilhesDepartment of Obstetrics & Gynecology, Bordeaux University Hospital, University of Bordeaux, Bordeaux, France.
Luis D PachecoDivision of Maternal-Fetal Medicine, Department of Obstetrics & Gynecology, The University of Texas Medical Branch at Galveston, Galveston, Texas, USA.
George SaadeDepartment of Obstetrics and Gynecology, Eastern Virginia Medical School, Norfolk, Virginia, USA.
Catherine Deneux-TharauxINSERM U1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Center for Epidemiology & Statistics Sorbonne Paris Cité, Paris Descartes University, Paris, France.
Amy BrennerCTU Global Health Trials Group, London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK.
Raoul MansukhaniCTU Global Health Trials Group, London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK.ORCID https://orcid.org/0000-0002-9456-5859
François-Xavier AgeronDepartment of Emergency Medicine, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland.
Danielle ProwseCTU Global Health Trials Group, London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK.
Rizwana ChaudhriRawalpindi Medical College, Rawalpindi, Pakistan.
Oladapo OlayemiUniversity of Ibadan College of Medicine, Ibadan, Nigeria.
Ian RobertsCTU Global Health Trials Group, London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTranexamic acid (TXA) reduces the risk of death and is recommended as a treatment for women with severe postpartum bleeding. There is hope that giving TXA shortly before or immediately after birth could prevent postpartum bleeding. Extending the use of TXA to prevent harmful postpartum bleeding could improve outcomes for millions of women; however we must carefully consider the balance of benefits and potential harms. This article describes the protocol for a systematic review and individual patient data (IPD) meta-analysis to assess the effectiveness and safety of TXA for preventing postpartum bleeding in all women giving birth, and to explore how the effects vary by underlying risk and other patient characteristics.   Methods: We will search for prospectively registered, randomised controlled trials involving 500 patients or more assessing the effects of TXA in women giving birth. Two authors will extract data and assess risk of bias. IPD data will be sought from eligible trials. Primary outcomes will be life-threatening bleeding and thromboembolic events. We will use a one-stage model to analyse the data. Subgroup analyses will be conducted to explore whether the effectiveness and safety of TXA varies by underlying risk, type birth, maternal haemoglobin (Hb), and timing of TXA. This protocol is registered on PROSPERO (CRD42022345775).  Conclusions: This systematic review and IPD meta-analysis will address important clinical questions about the effectiveness and safety of the use of TXA for the prevention of postpartum bleeding that cannot be answered reliably using aggregate data and will inform the decision of who to treat.   PROSPERO registration: CRD42022345775  Keywords   Anti-fibrinolytics; Tranexamic acid; childbirth; postpartum haemorrhage; meta-analysis.

Indexed as

Anti-fibrinolyticschildbirthmeta-analysispostpartum haemorrhageTranexamic acid

Identifiers

PMID37601311
PMCPMC10439279

What OpenQuestion holds

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Registered trials

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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.