Trial reportWomen's health (London, England)
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.
Trial report in Women's health (London, England). The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 6 of them syntheses that pooled it.
What it found
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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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
11 citing papers in PubMed, 6 syntheses or guidelines pooled it, 19 citations in OpenAlex.
- The efficacy of tranexamic acid for the prevention of postpartum hemorrhage among women at high risk of postpartum hemorrhage undergoing cesarean section: a meta-analysis.BMC pregnancy and childbirth · 2026Pooled it
- Clinical and healthcare systems-level interventions for postpartum hemorrhage prevention and management in Nigeria: a systematic review of effectiveness and implementation outcomes.Frontiers in health services · 2026Pooled it
- Efficacy of skin-to-skin contact between mother and newborn during the third stage of labour in reducing postpartum haemorrhage risk.BMC pregnancy and childbirth · 2025Pooled it
- Tranexamic acid for preventing postpartum haemorrhage after vaginal birth.The Cochrane database of systematic reviews · 2025Pooled it
- Pooled it
- Tranexamic acid for preventing postpartum haemorrhage after caesarean section.The Cochrane database of systematic reviews · 2024Pooled it
- Article
- Improving Obstetric Safety in Postpartum Hemorrhage: Impact of Protocol-Based Conservative Management.Life (Basel, Switzerland) · 2026Review
- 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
- Construction of a predictive model for the risk of postpartum hemorrhage in women with advanced maternal age undergoing natural childbirth.American journal of translational research · 2025Article
- Uses of tranexamic acid and the risk of thrombosis in women: Number 11 - 2025.Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors at 4 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPostpartum hemorrhage remains a leading cause of maternal mortality especially in developing countries. The majority of previous trials on the effectiveness of tranexamic acid in reducing blood loss were performed in low-risk women for postpartum hemorrhage. A recent Cochrane Systematic Review recommended that further research was needed to determine the effects of prophylactic tranexamic acid for preventing intraoperative blood loss in women at high risk of postpartum hemorrhage.
objectiveThis study aimed to evaluate the effectiveness and safety of tranexamic acid in reducing intraoperative blood loss when given prior to cesarean delivery in women at high risk of postpartum hemorrhage. STUDY
designThe study is a double-blind randomized controlled trial.
methodsThe study consisted of 200 term pregnant women and high-risk preterm pregnancies scheduled for lower-segment cesarean delivery at Enugu State University of Science and Technology, Teaching Hospital, Parklane, Enugu, Nigeria. The participants were randomized into two arms (intravenous 1 g of tranexamic acid or placebo) in a ratio of 1:1. The participants received either 1 g of tranexamic acid or placebo (20 mL of normal saline) intravenously at least 10 min prior to commencement of the surgery. The primary outcome measures were the mean intraoperative blood loss and hematocrit change 48 h postoperatively.
resultsThe baseline sociodemographic characteristics were similar in both groups. The tranexamic acid group when compared to the placebo group showed significantly lower mean blood loss (442.94 ± 200.97 versus 801.28 ± 258.68 mL; p = 0.001), higher mean postoperative hemoglobin (10.39 + 0.96 versus 9.67 ± 0.86 g/dL; p = 0.001), lower incidence of postpartum hemorrhage (1.0% versus 19.0%; p = 0.001), and lower need for use of additional uterotonic agents after routine management of the third stage of labor (39.0% versus 68.0%; p = 0.001), respectively. However, there was no significant difference in the mean preoperative hemoglobin (11.24 ± 0.88 versus 11.15 ± 0.90 g/dL; p = 0.457), need for other surgical intervention for postpartum hemorrhage (p > 0.05), and reported side effect, respectively, between the two groups.
conclusionProphylactic administration of tranexamic acid significantly decreases postpartum blood loss, improves postpartum hemoglobin, decreases the need for additional uterotonics, and prevents postpartum hemorrhage following cesarean section in pregnant women at high risk of postpartum hemorrhage. Its routine use during cesarean section in high-risk women may be encouraged.The trial was registered in the Pan-African Clinical Trial Registry with approval number
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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.