Abrham Mulugeta Shares Insights on Tranexamic Acid: Exploring the WHO WOMAN Trial
Abrham Mulugeta, Gynecologist at Tercha General Hospital, shared on LinkedIn:
”Drug review Tranexamic Acid (TXA)
Tranexamic Acid (TXA): Life-Saving Antifibrinolytic in Postpartum Hemorrhage (PPH)
TXA is a synthetic lysine analogue that inhibits fibrinolysis — stabilizing blood clots when every minute counts.
Mechanism:
Inhibits plasminogen activation → prevents fibrin degradation → promotes stable clot formation.
Dose (as per WHO and WOMAN trial):
1 g IV over 10 min, ideally within 3 hours of birth.
Repeat once after 30 min if bleeding continues or restarts.
Indicated for:
Treatment of postpartum hemorrhage (PPH) after vaginal or cesarean delivery.
Other indications according to local guidlines.
Evidence:
WOMAN Trial (Lancet 2017)
> 20 000+ women
→ Early TXA (≤3 h) ↓ maternal death due to bleeding by ~30 %.
Side effects:
Nausea, vomiting, dizziness
Rare: thromboembolic events → use cautiously in patients with active thrombosis
Key akeaway:
TXA reduces maternal mortality when given early alongside standard PPH management (uterotonics, IV fluids, surgical measures).
Timing matters — “The sooner, the stronger the benefit.”’
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