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RCOG statement on drug treatment for excessive blood loss after childbirth

News 28 April 2017

A major trial published in The Lancet shows that a cheap and widely available medication can reduce deaths from severe bleeding after childbirth, the leading cause of maternal mortality worldwide. The study of 20,000 women from 21 countries shows that maternal deaths were reduced by 31%, and urgent surgery to stop life-threatening bleeding was decreased by 36%, if the tranexamic acid was given within three hours of delivery. 

Professor Lesley Regan, President of the Royal College of Obstetricians and Gynaecologists (RCOG), said:

"The results of this important trial are very welcome and show that early administration of a cheap, widely available and heat-stable drug can reduce the number of maternal deaths from excessive bleeding after childbirth, also known as postpartum haemorrhage (PPH). The medication can also reduce the need for urgent surgery to stop life-threatening bleeding. 

"PPH is the leading cause of maternal death worldwide. More than 100,000 women die from the condition, mostly in low to middle income countries, every year. Although PPH is rare in the UK, there hasn’t been a significant reduction in the number of deaths from the condition since 2009. 

“Previous research has shown the benefits of the medication, but this latest study provides reassurance that there are no side effects from the drug for mothers or babies. The drug, called tranexamic acid (TXA), stabilises blood clots and prevents them from breaking down.

“PPH is an obstetric emergency and all staff involved in maternity care should have appropriate training to treat women who bleed excessively after childbirth. The RCOG guidelines provide clinicians with best-practice advice and guidance on preventing and treating the condition.”