Simple, Low-cost Tranexamic Drug Could Save Bleeding Mothers Post Childbirth

A widely available and inexpensive drug tranexamic acid could help to save lives of one in three mothers who bleed to death after childbirth, reveals a major study published in The Lancet. The research trial which was carried out on 20,000 women found that bleeding was reduced in around 31% of the patients if the treatment was given within three hours.

The World Health Organization guidelines also recommended the use of tranexamic acid in post-partum hemorrhage as a treatment option, if the uterotonic drugs fail to control the bleeding.

The study findings also showed that the drug was capable of reducing the need for surgery to control bleeding by 36%

Postpartum hemorrhage or severe bleeding that occurs in mothers after childbirth is the leading cause of maternal death worldwide. Around 100,000 women may die every year after childbirth. The condition occurs when there is more than 500ml of blood loss within 24 hours after childbirth.

The deaths due to postpartum hemorrhage are mostly either in low-and middle-income countries. Although, giving birth in a healthy facility increases survival in post-partum hemorrhage, there are still women who die from the condition even within the hospitals.

Research Study
The research trial WOMAN (World Maternal Antifibrinolytic) was conducted on mothers from 193 hospitals in 21 countries included mainly Africa and Asia.

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The study findings revealed that out of the women who were given tranexamic acid within the three hours, around 89 died due to bleeding when compared to 127 who were given a placebo.

There were no side-effects and researchers proved tranexamic acid to be a frontline treatment for post-partum hemorrhage.

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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."

Ian Roberts, Professor of Clinical Trials at the London School of Hygiene & Tropical Medicine, who co-led the study, said, "The researchers who invented tranexamic acid more than 50 years ago hoped it would reduce deaths from post-partum hemorrhage, but they couldn't persuade obstetricians at the time to conduct a trial. Now we finally have these results that we hope can help save women's lives around the world."

Tim Knott, Senior Partner in Innovations at Wellcome Trust, said, "Globally, severe bleeding in childbirth remains one of the main causes of maternal death - with alarming numbers of women dying in many low- and middle-income countries. The WOMAN Trial team undertook a hugely important and incredibly ambitious study. Their work stands to make a critical difference in preventing women dying after childbirth."

Even though the trial found the drug to be effective in reducing post-partum hemorrhage, hysterectomy (surgical procedure to remove the uterus) was not prevented. This is because in low-income countries, the procedure is followed immediately after the onset of severe bleeding before tranexamic acid could come to an effect.

Tranexamic Acid
The tranexamic acid belongs to a class of drugs called antifibrinolytics. It was first discovered by a Japanese couple Shosuke and Okamoto.

The drug mainly acts by stopping the blood clots from breaking down. It is available in the form of a tablet to be taken orally.

References

1. Haleema Shakur et al. Effect of early tranexamic acid administration on mortality, hysterectomy, and other morbidities in women with post-partum haemorrhage (WOMAN): an international, randomised, double-blind, placebo-controlled trial. The Lancet, April 2017 DOI: 10.1016/S0140-6736(17)30638-4
2. Tranexamic Acid - (https://medlineplus.gov/druginfo/meds/a612021.html)

Source-Medindia