Tranexamic Acid to Prevent Obstetrical Hemorrhage after Cesarean Delivery
Primary resultResult — go to the resultAdjusted relative risk 0.89 95.26% CI 0.74–1.07Authors' conclusion
Prophylactic 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.
Study context
- Population
- Patients undergoing cesarean delivery at 31 US hospitals
- Participants
- 11,000 patients
- Comparison
- TXA vs placebo after umbilical-cord clamping
- Tranexamic acidn = 5,529
- Placebon = 5,471reference
- Primary endpoint
- Composite of:
- Maternal death
- Blood transfusion
- Follow-up
- By hospital discharge or 7 days post partum, whichever came first
Methodological detailsplacebo-controlled, multicentre
- Placebo-controlled
- Multicentre
Primary result
As reported in the abstract
Adjusted relative risk
0.89
95.26% CI 0.74–1.07
P = 0.19
Events by treatment group
Tranexamic acid vs Placebo
adjusted RR 0.89 (95.26% CI 0.74–1.07); P = 0.19
Secondary outcomes
| Outcome | Tranexamic acid | Placebo | RR (95% CI) | |
|---|---|---|---|---|
| Estimated intraoperative blood loss >1 liter (major secondary outcome) | 7.3% | 8.0% | 0.91 (0.79–1.05) | |
| Interventions for bleeding complications | 16.1% | 18.0% | 0.90 (0.82–0.97) | |
| 0.512Relative risk (log scale) |
g per deciliter
| Outcome | Tranexamic acid | Placebo | Mean difference (g per deciliter) (95% CI) | |
|---|---|---|---|---|
| Change in hemoglobin level (preoperative to postoperative) | −1.8 | −1.9 | −0.1 (−0.2 to −0.1) | |
| −0.3−0.2−0.100.1Difference, g per deciliter (linear scale) |
Safety
| Outcome | Tranexamic acid | Placebo | RR (95% CI) | |
|---|---|---|---|---|
| Postpartum infectious complications | 3.2% | 2.5% | 1.28 (1.02–1.61) | |
| 0.512Relative risk (log scale) |
Thromboembolic events and other adverse events
- Similar in the two groups
Original publication
Tranexamic Acid to Prevent Obstetrical Hemorrhage after Cesarean Delivery. N Engl J Med. Published 13 April 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →