Postpartum hemorrhage (PPH) occurs in up to one in ten deliveries worldwide and is the
leading cause of maternal morbidity and mortality. In developing countries 30% of women
develop PPH because access to a number of treatments is not readily available. Interestingly,
the rate of PPH and consequently of maternal morbidity has increased significantly even in
developed nations, such as Canada, over the past decades. This rate is also increasing
amongst parturients in Ontario. Unfortunately, few effective preventative treatments exist.
Antifibrinolytic drugs are routinely used to reduce bleeding and the requirement for blood
transfusions in a wide range of hemorrhagic conditions. The most commonly used
antifibrinolytic drug is tranexamic acid (TXA). TXA is safe, affordable, with very few side
effects. The World Health Organization recommended that TXA be used to reduce blood loss in
several conditions, including in patients with established PPH refractory to conventional
therapy.However, little is known about the prophylactic use of TXA to prevent PPH.