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Systematic review with meta analysis
Prophylactic tranexamic acid in addition to uterotonics may prevent blood loss for vaginal and caesarean deliveries
  1. Loïc Sentilhes1,
  2. Catherine Deneux-Tharaux2
  1. 1Bordeaux University Hospital, Bordeaux, Aquitaine, France
  2. 2INSERM, Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Center for Epidemiology and Biostatistics (U1153), Paris-Descartes University, Paris, France
  1. Correspondence to : Professor Loïc Sentilhes, Department of Obstetrics and Gynecology, Angers University Hospital, Place Amélie Raba Léon, Bordeaux 33076, France; loicsentilhest{at}hotmail.com

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Postpartum haemorrhage (PPH) as defined by blood loss >500 mL occurs in 3–15% of deliveries, leads to a life-threatening event in one out of five cases, and is responsible for about 25% of all maternal deaths worldwide.1 During delivery, a sequence of physiological and haemostatic changes occurs that reduces bleeding, in particular strong myometrial contractions, and increase in the fibrinolytic activity.2 To date, only the use of uterotonics has been shown to be effective in preventing PPH and is widely recommended by all authorities after vaginal or caesarean deliveries.1 Tranexamic acid (TXA), an antifibrinolytic agent, reduces transfusion in elective surgical patients, mortality in bleeding trauma patients, and menstrual blood loss in women with menorrhagia. …

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