Tranexamic acid for treatment of postpartum haemorrhage

Abstract Postpartum haemorrhage remains the leading cause of maternal mortality globally. Mortality and severe morbidity due to postpartum haemorrhage is highest in lower-resource settings. Tranexamic acid is an anti-fibrinolytic drug that has been in use in humans for nearly five decades. It is a structural analogue of lysine that binds irreversibly to plasminogen, thereby inhibiting the binding of plasmin to fibrin. This in turn inhibits fibrinolysis, thus stabilizing blood clots. Tranexamic acid has been shown to improve outcomes in trauma-related bleeding. New research has shown that early use of tranexamic acid (within 3 hours of birth), in addition to standard care, safely reduces deaths due to bleeding in women with clinically diagnosed postpartum haemorrhage, regardless of the mode of birth.