Treatment for severe bleeding could save lives of mothers around the world

New evidence suggests low-cost drug should become frontline response for major blood loss after childbirth.

An inexpensive and widely available drug could save the lives of one in three mothers who would otherwise bleed to death after childbirth, according to a major study.

The global trial of 20,000 women found that death due to bleeding was reduced by 31percent if the treatment was given within three hours.

The drug, called tranexamic acid (TXA), works by stopping blood clots from breaking down. The findings also show it reduced the need for urgent surgery to control bleeding (laparotomy) by more than a third (36percent).

Severe bleeding after childbirth (known as post-partum haemorrhage or PPH) is the leading cause of maternal death worldwide. More than 100,000 women globally die each year from the condition, but this clot-stabilising drug has the potential to reduce the number substantially.

The WOMAN (World Maternal Antifibrinolytic) Trial recruited mothers from 193 hospitals in 21 countries, mainly in Africa and Asia, but also in the UK and elsewhere. The London School of Hygiene & Tropical Medicine coordinated the trial. It was funded by The Wellcome Trust and UK Department of Health through the Health Innovation Challenge Fund, and the Bill & Melinda Gates Foundation.

The results show that of the women given tranexamic acid within three hours, 89 died from bleeding compared with 127 given placebo (in addition to standard care). The researchers found no side effects from the drug for either mothers or babies. These findings provide the first comprehensive evidence on using tranexamic acid for post-partum haemorrhage and suggest it should be used as a frontline treatment.

Haleema Shakur, Associate Professor of Clinical Trials at the London School of Hygiene & Tropical Medicine and Project Director on the WOMAN Trial, said: ‘We now have important evidence that the early use of tranexamic acid can save women’s lives and ensure more children grow up with a mother. It’s safe, affordable and easy to administer, and we hope that doctors will use it as early as possible following the onset of severe bleeding after childbirth.’

Tranexamic acid was invented in the 1960s by a Japanese husband and wife research team, Shosuke and Utako Okamoto.

London School of Hygiene & Tropical Medicinewww.lshtm.ac.uk/newsevents/news/2017/woman_trial_results.html