Trends in the Administration of Tranexamic Acid for Postpartum Hemorrhage

NCT07278037 | Recruiting DMC

• 2 other identifiers: 776/2568(IRB3)Si 717/2025
• Study Type: observational
• Target: 648
• Locations: 1 country
• Sites: 1

Brief Summary

Postpartum hemorrhage (PPH) is the global leading cause of maternal death, with 20-30% of maternal deaths in Thailand linked to hemorrhage. The WOMAN Trial (2017) provided strong evidence that administering tranexamic acid (TXA)within three hours of bleeding onset lowered PPH-related mortality by 31%. Consequently, the World Health Organization (WHO) updated its guidelines, recommending TXA as part of the standard treatment package for all PPH cases. Following this, the use of TXA has been widely adopted globally and increased in Thailand. A recent study at a major Thai university hospital observed a significant increase in TXA administration after 2017. The current study aims to further analyze the recent growth rate of TXA use and its impact on obstetric and perinatal outcomes during cesarean deliveries with PPH.

Conditions

Postpartum Hemorrhage; Delivery Complication; Cesarean Section Complications; Perinatal Problems

Keywords

cesarean delivery; complications; postpartum hemorrhage; tranexamic acid

Outcome Measures

Primary Outcomes (1)

• Rate of tranexamic acid administration divided by year

  Number of patients received tranexamic acid after diagnosis of postpartum hemorrhage

  Within 24 hours after delivery

Secondary Outcomes (9)

• Quantity of blood loss

  Within 24 hours after delivery

• Number of patients received blood transfusion

  Within 24 hours after delivery

• Number of patients received additional obstetrical interventions

  Within 24 hours after delivery

• Number of patients receive reoperation

  Within 24 hours after delivery

• Causes of postpartum hemorrhage

  Within 24 hours after delivery

Study Arms (2)

Tranexamic acid group

Patients received tranexamic acid after postpartum hemorrhage

Drug: Tranexamic acid

Non tranexamic acid group

Patients did not receive tranexamic acid after postpartum hemorrhage

Interventions

Tranexamic acid DRUG

The number of patients received tranexamic acid after postpartum hemorrhage

Also known as: TXA

Tranexamic acid group

Eligibility Criteria

• Sex: female
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Patients underwent cesarean delivery with diagnosis of primary postpartum hemorrhage at Siriraj Hospital, Bangkok, Thailand

You may qualify if:

• \. Patients underwent cesarean delivery with primary postpartum hemorrhage

You may not qualify if:

• Gestational age at less than 24 weeks
• Absence of the anesthetic record
• Received tranexamic acid in the antepartum period
• Blood loss less than 1,000 ml

Sponsors & Collaborators

• Mahidol University: lead

Study Sites (1)

Siriraj Hospital

Bangkoknoi, Bangkok, 10700, Thailand

RECRUITING

MeSH Terms

Conditions

Postpartum Hemorrhage

Interventions

Tranexamic Acid

Condition Hierarchy (Ancestors)

Obstetric Labor Complications; Pregnancy Complications; Female Urogenital Diseases and Pregnancy Complications; Urogenital Diseases; Puerperal Disorders; Uterine Hemorrhage; Hemorrhage; Pathologic Processes; Pathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

Cyclohexanecarboxylic Acids; Acids, Carbocyclic; Carboxylic Acids; Organic Chemicals

Study Officials

• Patchareya Nivatpumin, M.D.

  Siriraj Hospital

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Patchareya Nivatpumin, M.D.

CONTACT

+66896662187; patcahreya.niv@mahidol.ac.th

Premyuda Matangkarat, M.D.

CONTACT

+66959472598; premyuda.mat@mahidol.ac.th

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: November 30, 2025
• First Posted: December 11, 2025
• Study Start: December 1, 2025
• Primary Completion: March 31, 2026
• Study Completion (Estimated): September 30, 2026
• Last Updated: December 22, 2025

Record last verified: 2025-12

Locations

TH (1)