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Updated WHO recommendation on tranexamic acid for the treatment of postpartum haemorrhage. Highlights and key messages from the World Health Organization's 2017 Global Recommendation.
Geneva, Switzerland, WHO, 2017 Oct. 5 p. (WHO/RHR/17.21)This summary brief highlights key messages from the updated World Health Organization’s recommendation on Tranexamic acid (TXA) for the treatment of postpartum haemorrhage (PPH), including policy and program implications for translating the TXA recommendation into action at the country level. In 2012, WHO published recommendations for the prevention and treatment of postpartum haemorrhage, including a recommendation on the use of tranexamic acid (TXA) for treatment of PPH. The 2017 updated WHO Recommendation on TXA is based on new evidence on use of TXA for treatment of PPH. Key messages include: 1) The World Health Organization (WHO) recommends early use of intravenous tranexamic acid (TXA) within 3 hours of birth in addition to standard care for women with clinically diagnosed postpartum haemorrhage (PPH) following vaginal birth or caesarean section; 2) Administration of TXA should be considered as part of the standard PPH treatment package and be administered as soon as possible after onset of bleeding and within 3 hours of birth. TXA for PPH treatment should not be initiated more than 3 hours after birth; 3) TXA should be used in all cases of PPH, regardless of whether the bleeding is due to genital tract trauma or other causes; 4) TXA should be administered at a fixed dose of 1 g in 10 mL (100 mg/mL) IV at 1 mL per minute (i.e., administered over 10 minutes), with a second dose of 1 g IV if bleeding continues after 30 minutes; and 5) TXA should be administered via an IV route only for treatment of PPH. Research on other routes of TXA administration is a priority.This summary brief is intended for policy-makers, programme managers, educators and providers.