Tranexamic acid for post-partum haemorrhage in the WOMAN trial

Autores
Miller, Suellen; Burke, Thomas; Belizan, Jose; Fuchtner, Carlos; Lalonde, Andre; Malhorta, Jaideep
Año de publicación
2017
Idioma
inglés
Tipo de recurso
artículo
Estado
versión publicada
Descripción
As clinicians and researchers of post-partum haemorrhage, we appreciate the clinical trial of tranexamic acid1 and applaud the researchers and results. We want to emphasise the importance of the addition of tranexamic acid to other technologies and strategies to form a complete comprehensive package for post-partum haemorrhage (or emergency post-partum haemorrhage bundle),2 which begins at the community level and proceeds, with attention to context, through primary health care to the referral-hospital level. As the authors note, tranexamic acid was tested at higher-level facilities (ie, secondary and tertiary hospitals) with providers not only able to give intravenous injections, but who were skilled enough (and equipped) to deliver a 1 mL/min dose of 1 g tranexamic acid, do hysterectomy or laparotomy, and give blood transfusions. Furthermore, the findings suggested early (<3 h) treatment with tranexamic acid, which is not always possible given the distances and delays women face in the settings of the community or primary health care. It could be some time before the bioavailability and correct dose of alternative routes have been trialled. For now in the setting of the community or primary health care, in which intravenous injections are neither safe nor feasible, and in higher-level facilities, in which a woman could arrive more than 3 h after the haemorrhage starts, a comprehensive continuum of care for post-partum haemorrhage is needed.3 At lower-level health-care facilities (ie, primary health care and dispensaries) the uterine balloon tamponade (as a packaged kit)4 and non-pneumatic antishock garment5 could save lives and buy time for referral and transportation delays. These interventions should be used together when necessary (in cases of shock) and should both decrease blood loss and cause clot formation, so that they can be effective with tranexamic acid. SM holds a faculty position at the University of California, San Francisco, which holds the right to the trademark LifeWrap (one brand of NASG) and has licensed this trademark to the BlueFuzion Group. BlueFuzion Group pays the University of California, San Francisco a royalty of 2·5% for the use of the trademark LifeWrap. All other authors declare no competing interests.
Fil: Miller, Suellen. University of California; Estados Unidos
Fil: Burke, Thomas. Massachusetts General Hospital; Estados Unidos
Fil: Belizan, Jose. Instituto de Efectividad Clínica y Sanitaria; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina
Fil: Fuchtner, Carlos. International Federation Of Gynecology And Obstetrics; Bolivia
Fil: Lalonde, Andre. McGill University; Canadá. University of Ottawa; Canadá
Fil: Malhorta, Jaideep. Rainbow Hospitals; India
Materia
Tranexamic acid
post-partum haemorrhage
Nivel de accesibilidad
acceso abierto
Condiciones de uso
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
Repositorio
CONICET Digital (CONICET)
Institución
Consejo Nacional de Investigaciones Científicas y Técnicas
OAI Identificador
oai:ri.conicet.gov.ar:11336/94487

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network_name_str CONICET Digital (CONICET)
spelling Tranexamic acid for post-partum haemorrhage in the WOMAN trialMiller, SuellenBurke, ThomasBelizan, JoseFuchtner, CarlosLalonde, AndreMalhorta, JaideepTranexamic acidpost-partum haemorrhagehttps://purl.org/becyt/ford/3.3https://purl.org/becyt/ford/3As clinicians and researchers of post-partum haemorrhage, we appreciate the clinical trial of tranexamic acid1 and applaud the researchers and results. We want to emphasise the importance of the addition of tranexamic acid to other technologies and strategies to form a complete comprehensive package for post-partum haemorrhage (or emergency post-partum haemorrhage bundle),2 which begins at the community level and proceeds, with attention to context, through primary health care to the referral-hospital level. As the authors note, tranexamic acid was tested at higher-level facilities (ie, secondary and tertiary hospitals) with providers not only able to give intravenous injections, but who were skilled enough (and equipped) to deliver a 1 mL/min dose of 1 g tranexamic acid, do hysterectomy or laparotomy, and give blood transfusions. Furthermore, the findings suggested early (<3 h) treatment with tranexamic acid, which is not always possible given the distances and delays women face in the settings of the community or primary health care. It could be some time before the bioavailability and correct dose of alternative routes have been trialled. For now in the setting of the community or primary health care, in which intravenous injections are neither safe nor feasible, and in higher-level facilities, in which a woman could arrive more than 3 h after the haemorrhage starts, a comprehensive continuum of care for post-partum haemorrhage is needed.3 At lower-level health-care facilities (ie, primary health care and dispensaries) the uterine balloon tamponade (as a packaged kit)4 and non-pneumatic antishock garment5 could save lives and buy time for referral and transportation delays. These interventions should be used together when necessary (in cases of shock) and should both decrease blood loss and cause clot formation, so that they can be effective with tranexamic acid. SM holds a faculty position at the University of California, San Francisco, which holds the right to the trademark LifeWrap (one brand of NASG) and has licensed this trademark to the BlueFuzion Group. BlueFuzion Group pays the University of California, San Francisco a royalty of 2·5% for the use of the trademark LifeWrap. All other authors declare no competing interests.Fil: Miller, Suellen. University of California; Estados UnidosFil: Burke, Thomas. Massachusetts General Hospital; Estados UnidosFil: Belizan, Jose. Instituto de Efectividad Clínica y Sanitaria; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Fuchtner, Carlos. International Federation Of Gynecology And Obstetrics; BoliviaFil: Lalonde, Andre. McGill University; Canadá. University of Ottawa; CanadáFil: Malhorta, Jaideep. Rainbow Hospitals; IndiaElsevier Science Inc2017-09info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/resource_type/c_6501info:ar-repo/semantics/articuloapplication/pdfapplication/pdfapplication/pdfapplication/pdfhttp://hdl.handle.net/11336/94487Miller, Suellen; Burke, Thomas; Belizan, Jose; Fuchtner, Carlos; Lalonde, Andre; et al.; Tranexamic acid for post-partum haemorrhage in the WOMAN trial; Elsevier Science Inc; Lancet; 390; 10102; 9-2017; 15830140-6736CONICET DigitalCONICETenginfo:eu-repo/semantics/altIdentifier/url/https://www.sciencedirect.com/science/article/pii/S014067361732408Xinfo:eu-repo/semantics/altIdentifier/doi/10.1016/S0140-6736(17)32408-Xinfo:eu-repo/semantics/openAccesshttps://creativecommons.org/licenses/by-nc-sa/2.5/ar/reponame:CONICET Digital (CONICET)instname:Consejo Nacional de Investigaciones Científicas y Técnicas2025-09-29T09:44:41Zoai:ri.conicet.gov.ar:11336/94487instacron:CONICETInstitucionalhttp://ri.conicet.gov.ar/Organismo científico-tecnológicoNo correspondehttp://ri.conicet.gov.ar/oai/requestdasensio@conicet.gov.ar; lcarlino@conicet.gov.arArgentinaNo correspondeNo correspondeNo correspondeopendoar:34982025-09-29 09:44:41.459CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicasfalse
dc.title.none.fl_str_mv Tranexamic acid for post-partum haemorrhage in the WOMAN trial
title Tranexamic acid for post-partum haemorrhage in the WOMAN trial
spellingShingle Tranexamic acid for post-partum haemorrhage in the WOMAN trial
Miller, Suellen
Tranexamic acid
post-partum haemorrhage
title_short Tranexamic acid for post-partum haemorrhage in the WOMAN trial
title_full Tranexamic acid for post-partum haemorrhage in the WOMAN trial
title_fullStr Tranexamic acid for post-partum haemorrhage in the WOMAN trial
title_full_unstemmed Tranexamic acid for post-partum haemorrhage in the WOMAN trial
title_sort Tranexamic acid for post-partum haemorrhage in the WOMAN trial
dc.creator.none.fl_str_mv Miller, Suellen
Burke, Thomas
Belizan, Jose
Fuchtner, Carlos
Lalonde, Andre
Malhorta, Jaideep
author Miller, Suellen
author_facet Miller, Suellen
Burke, Thomas
Belizan, Jose
Fuchtner, Carlos
Lalonde, Andre
Malhorta, Jaideep
author_role author
author2 Burke, Thomas
Belizan, Jose
Fuchtner, Carlos
Lalonde, Andre
Malhorta, Jaideep
author2_role author
author
author
author
author
dc.subject.none.fl_str_mv Tranexamic acid
post-partum haemorrhage
topic Tranexamic acid
post-partum haemorrhage
purl_subject.fl_str_mv https://purl.org/becyt/ford/3.3
https://purl.org/becyt/ford/3
dc.description.none.fl_txt_mv As clinicians and researchers of post-partum haemorrhage, we appreciate the clinical trial of tranexamic acid1 and applaud the researchers and results. We want to emphasise the importance of the addition of tranexamic acid to other technologies and strategies to form a complete comprehensive package for post-partum haemorrhage (or emergency post-partum haemorrhage bundle),2 which begins at the community level and proceeds, with attention to context, through primary health care to the referral-hospital level. As the authors note, tranexamic acid was tested at higher-level facilities (ie, secondary and tertiary hospitals) with providers not only able to give intravenous injections, but who were skilled enough (and equipped) to deliver a 1 mL/min dose of 1 g tranexamic acid, do hysterectomy or laparotomy, and give blood transfusions. Furthermore, the findings suggested early (<3 h) treatment with tranexamic acid, which is not always possible given the distances and delays women face in the settings of the community or primary health care. It could be some time before the bioavailability and correct dose of alternative routes have been trialled. For now in the setting of the community or primary health care, in which intravenous injections are neither safe nor feasible, and in higher-level facilities, in which a woman could arrive more than 3 h after the haemorrhage starts, a comprehensive continuum of care for post-partum haemorrhage is needed.3 At lower-level health-care facilities (ie, primary health care and dispensaries) the uterine balloon tamponade (as a packaged kit)4 and non-pneumatic antishock garment5 could save lives and buy time for referral and transportation delays. These interventions should be used together when necessary (in cases of shock) and should both decrease blood loss and cause clot formation, so that they can be effective with tranexamic acid. SM holds a faculty position at the University of California, San Francisco, which holds the right to the trademark LifeWrap (one brand of NASG) and has licensed this trademark to the BlueFuzion Group. BlueFuzion Group pays the University of California, San Francisco a royalty of 2·5% for the use of the trademark LifeWrap. All other authors declare no competing interests.
Fil: Miller, Suellen. University of California; Estados Unidos
Fil: Burke, Thomas. Massachusetts General Hospital; Estados Unidos
Fil: Belizan, Jose. Instituto de Efectividad Clínica y Sanitaria; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina
Fil: Fuchtner, Carlos. International Federation Of Gynecology And Obstetrics; Bolivia
Fil: Lalonde, Andre. McGill University; Canadá. University of Ottawa; Canadá
Fil: Malhorta, Jaideep. Rainbow Hospitals; India
description As clinicians and researchers of post-partum haemorrhage, we appreciate the clinical trial of tranexamic acid1 and applaud the researchers and results. We want to emphasise the importance of the addition of tranexamic acid to other technologies and strategies to form a complete comprehensive package for post-partum haemorrhage (or emergency post-partum haemorrhage bundle),2 which begins at the community level and proceeds, with attention to context, through primary health care to the referral-hospital level. As the authors note, tranexamic acid was tested at higher-level facilities (ie, secondary and tertiary hospitals) with providers not only able to give intravenous injections, but who were skilled enough (and equipped) to deliver a 1 mL/min dose of 1 g tranexamic acid, do hysterectomy or laparotomy, and give blood transfusions. Furthermore, the findings suggested early (<3 h) treatment with tranexamic acid, which is not always possible given the distances and delays women face in the settings of the community or primary health care. It could be some time before the bioavailability and correct dose of alternative routes have been trialled. For now in the setting of the community or primary health care, in which intravenous injections are neither safe nor feasible, and in higher-level facilities, in which a woman could arrive more than 3 h after the haemorrhage starts, a comprehensive continuum of care for post-partum haemorrhage is needed.3 At lower-level health-care facilities (ie, primary health care and dispensaries) the uterine balloon tamponade (as a packaged kit)4 and non-pneumatic antishock garment5 could save lives and buy time for referral and transportation delays. These interventions should be used together when necessary (in cases of shock) and should both decrease blood loss and cause clot formation, so that they can be effective with tranexamic acid. SM holds a faculty position at the University of California, San Francisco, which holds the right to the trademark LifeWrap (one brand of NASG) and has licensed this trademark to the BlueFuzion Group. BlueFuzion Group pays the University of California, San Francisco a royalty of 2·5% for the use of the trademark LifeWrap. All other authors declare no competing interests.
publishDate 2017
dc.date.none.fl_str_mv 2017-09
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
http://purl.org/coar/resource_type/c_6501
info:ar-repo/semantics/articulo
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/11336/94487
Miller, Suellen; Burke, Thomas; Belizan, Jose; Fuchtner, Carlos; Lalonde, Andre; et al.; Tranexamic acid for post-partum haemorrhage in the WOMAN trial; Elsevier Science Inc; Lancet; 390; 10102; 9-2017; 1583
0140-6736
CONICET Digital
CONICET
url http://hdl.handle.net/11336/94487
identifier_str_mv Miller, Suellen; Burke, Thomas; Belizan, Jose; Fuchtner, Carlos; Lalonde, Andre; et al.; Tranexamic acid for post-partum haemorrhage in the WOMAN trial; Elsevier Science Inc; Lancet; 390; 10102; 9-2017; 1583
0140-6736
CONICET Digital
CONICET
dc.language.none.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv info:eu-repo/semantics/altIdentifier/url/https://www.sciencedirect.com/science/article/pii/S014067361732408X
info:eu-repo/semantics/altIdentifier/doi/10.1016/S0140-6736(17)32408-X
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
eu_rights_str_mv openAccess
rights_invalid_str_mv https://creativecommons.org/licenses/by-nc-sa/2.5/ar/
dc.format.none.fl_str_mv application/pdf
application/pdf
application/pdf
application/pdf
dc.publisher.none.fl_str_mv Elsevier Science Inc
publisher.none.fl_str_mv Elsevier Science Inc
dc.source.none.fl_str_mv reponame:CONICET Digital (CONICET)
instname:Consejo Nacional de Investigaciones Científicas y Técnicas
reponame_str CONICET Digital (CONICET)
collection CONICET Digital (CONICET)
instname_str Consejo Nacional de Investigaciones Científicas y Técnicas
repository.name.fl_str_mv CONICET Digital (CONICET) - Consejo Nacional de Investigaciones Científicas y Técnicas
repository.mail.fl_str_mv dasensio@conicet.gov.ar; lcarlino@conicet.gov.ar
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