Key clinical point: A dose of 1 g intravenous tranexamic acid vs placebo significantly inhibited postpartum hemorrhage-induced hyperfibrinolysis during cesarean delivery.
Major finding: A dose of 1 g tranexamic acid vs placebo significantly inhibited postpartum hemorrhage-induced hyperfibrinolysis as evidenced by smaller mean increases in D-dimer levels at 120 minutes (38% vs 93%; P = .003) and plasmin-antiplasmin levels at 30 minutes (−2% vs 56%; P = .009) after the initiation of infusion but with more frequent nonserious adverse events, such as nausea and vomiting, whereas 0.5 g tranexamic acid did not lead to significant hyperfibrinolysis inhibition.
Study details: The data come from the phase 4 TRACES trial including 151 women who experienced postpartum hemorrhage during cesarean delivery and were randomly assigned to receive tranexamic acid (0.5 or 1 g) or placebo.
Disclosures: This study was supported by the French Ministry of Health and the French National Drug Safety Agency. The authors declared no conflicts of interest.
Source: Ducloy-Bouthors AS et al for the TRACES working group. Tranexamic acid dose-response relationship for antifibrinolysis in postpartum haemorrhage during caesarean delivery: TRACES, a double-blind, placebo-controlled, multicentre, dose-ranging biomarker study. Br J Anaesth. 2022;129(6):937-945 (Oct 12). Doi: 10.1016/j.bja.2022.08.033