Articles  |   August 2018
SEE Question
Article Information
Cardiovascular Anesthesia / Coagulation and Transfusion / Obstetric Anesthesia / Articles
Articles   |   August 2018
SEE Question
ASA Monitor 8 2018, Vol.82, 50-51.
ASA Monitor 8 2018, Vol.82, 50-51.
A 25-year-old woman is undergoing emergency cesarean delivery due to placental abruption and an abnormal fetal heart tracing. After delivery of the neonate, bleeding is brisk. The estimated blood loss is 1,600 mL and is continuing. You decide to administer 1 g of tranexamic acid (TXA). Based on the results of a large multinational study, which of the following is the most likely outcome compared to a patient receiving standard treatment without TXA for postpartum hemorrhage (PPH)?
PPH remains a major and preventable cause of maternal mortality throughout the world, accounting for approximately 100,000 deaths each year. Many strategies have been used to decrease the rate of this devastating outcome. The administration of TXA has become a common strategy to decrease blood loss in some surgical populations, including orthopedic and trauma patients. In trauma patients, it has been shown to decrease death due to bleeding. Some have advocated its use for PPH, but due to the hypercoagulable state of pregnancy, a group of researchers felt that additional evidence of TXA’s safety and efficacy was needed before its routine use for PPH could be advocated. Therefore, the double-blinded, placebo-controlled World Maternal Antifibrinolytic (WOMAN) trial was under-taken in parturients diagnosed with PPH.
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