New World Health Organization (WHO) guidelines use evidence from the WOMAN trial to recommend use of blood haemorrhaging treatment

The World Health Organization (WHO) is recommending early use of tranexamic acid to treat bleeding post childbirth after fresh analysis of the WOMAN trial was published in The Lancet.

Results from the WOMAN trial, led locally by Dr Clare Tower, Consultant in Obstetrics and Maternal and Fetal Medicine, were published earlier this year in The Lancet. Findings from the trial showed that women who receive tranexamic acid (TXA) for post-partum haemorrhaging (PPH) within the first couple of hours of bleeding have a significantly better survival rate.

PPH is to date the most common cause of maternal death. Every year 14million mothers will develop PPH and around 2% of these women will die within 2-4 hours from the start of bleeding. This means that across the world, one woman will die every five minutes and 100,000 babies will lose their mothers during childbirth or shortly afterwards from excessive bleeding.

The study looked at 20,000 women across 21 countries and examined the potential lifesaving benefits of TXA.  In Manchester, Dr Tower and a team of research midwives recruited 38 women into the study.

The World Health Organisation (WHO) has now published updated guidance strongly recommending that intravenous TXA is given to women diagnosed with severe bleeding within three hours of them giving birth. The previous guidelines in 2012 – before the WOMAN Trial results were known – recommended use of tranexamic acid if other treatments failed. WHO also highlighted the need for all health systems, regardless of their level of resources, to recognise that tranexamic acid is a life-saving intervention that should be made readily available for PPH management wherever emergency obstetric care is provided. TXA is now an important part of clinical management of PPH at Saint Mary’s Hospital.

The trial was coordinated by the London School of Hygiene & Tropical Medicine’s Clinical Trials Unit and supported by the National Institute for Health Research (NIHR), Pfizer, UK Department of Health, Wellcome Trust, and Bill & Melinda Gates Foundation.

Read more about the WOMAN trial here: