Tranexamic acid use for heavy bleeding after cesarean delivery
A Retrospective Analysis of the Longitudinal Pattern of Tranexamic Acid Administration in Parturients Undergoing Cesarean Delivery Complicated by Postpartum Hemorrhage
This study will test whether wider use of tranexamic acid for heavy postpartum bleeding during cesarean delivery is linked to better outcomes for mothers and babies.
Quick facts
| Study type | Observational |
|---|---|
| Enrollment | 648 (estimated) |
| Sex | Female |
| Sponsor | Mahidol University Academic / other |
| Locations | 1 site (Bangkoknoi, Bangkok) |
| Trial ID | NCT07278037 on ClinicalTrials.gov |
What this trial studies
This is an observational, retrospective analysis of cesarean deliveries complicated by primary postpartum hemorrhage at Siriraj Hospital, Mahidol University. Investigators will measure how often tranexamic acid (TXA) has been used over recent years and calculate the growth rate of its use after publication of major guidelines. The study will compare obstetric and perinatal outcomes—such as need for blood transfusion, additional surgical interventions, and neonatal status—between cases that did and did not receive TXA, using hospital records and anesthetic charts. Patients with gestational age <24 weeks, antepartum TXA exposure, missing anesthetic records, or blood loss <1,000 ml are excluded from analysis.
Who should consider this trial
Good fit: Ideal candidates are women who experienced primary postpartum hemorrhage of 1,000 ml or more during cesarean delivery with complete anesthetic records at Siriraj Hospital.
Not a fit: Women with gestational age under 24 weeks, those who received tranexamic acid before delivery, cases with blood loss under 1,000 ml, or lacking anesthetic records would not be included and thus would not benefit from this analysis.
Why it matters
Potential benefit: If increased TXA use is associated with better outcomes, the findings could support broader, timely use of TXA to reduce bleeding-related complications and deaths after cesarean delivery.
How similar studies have performed: The large WOMAN randomized trial (2017) showed a 31% reduction in PPH-related mortality when TXA was given within three hours, and subsequent implementation reports have documented increased TXA adoption.
Eligibility criteria
Show full inclusion / exclusion criteria
Inclusion Criteria: * 1\. Patients underwent cesarean delivery with primary postpartum hemorrhage Exclusion Criteria: 1. Gestational age at less than 24 weeks 2. Absence of the anesthetic record 3. Received tranexamic acid in the antepartum period 4. Blood loss less than 1,000 ml
Where this trial is running
Bangkoknoi, Bangkok
- Siriraj Hospital — Bangkoknoi, Bangkok, Thailand (Recruiting)
Study contacts
- Principal investigator: Patchareya Nivatpumin, M.D. — Siriraj Hospital
- Study coordinator: Patchareya Nivatpumin, M.D.
- Email: patcahreya.niv@mahidol.ac.th
- Phone: +66896662187
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.