EFFICACY OF TRANEXAMIC ACID IN THE PREVENTION OF POSTPARTUM HEMORRHAGE: A NARRATIVE LITERATURE REVIEW

Autores

  • Kellen de Pícoli Alexandre
  • Rodolfo de Oliveira Medeiros
  • Cristiano Machado Galhardi
  • Melissa Antunes
  • Marília Bedani de Oliveira
  • Felipe Colatto Alves
  • Ana Clara Moreira Seabra
  • Hacise Colatto
  • Laysa Ohana Mada
  • Felipe Ravazzi Guzzo
  • Maria Victoria Santos Kloster
  • Eduardo Antônio Ferro Faria
  • Izabela Manfio Rorato

DOI:

https://doi.org/10.36557/2674-9432.2026v5n3p512-521

Palavras-chave:

Postpartum Hemorrhage; Tranexamic Acid; Prevention; Maternal Health

Resumo

Postpartum hemorrhage (PPH) remains one of the leading causes of maternal morbidity and mortality worldwide, requiring effective strategies for prevention, early recognition, and timely management. In this context, tranexamic acid has been investigated as a pharmacological intervention capable of reducing obstetric blood loss through inhibition of fibrinolysis. This study aimed to analyze the efficacy of tranexamic acid in the prevention of postpartum hemorrhage based on contemporary scientific literature. This is a narrative literature review conducted through searches in databases such as PubMed, Scopus, and the Virtual Health Library, using descriptors related to tranexamic acid, postpartum hemorrhage, and prevention. Studies published between 2018 and 2026 were prioritized, including randomized clinical trials, systematic reviews, international recommendations, and clinical guidelines. Findings indicate that tranexamic acid may reduce blood loss during childbirth, particularly in cesarean deliveries, although its effectiveness in reducing major clinical outcomes such as transfusion and maternal mortality remains inconsistent. In vaginal deliveries, recent evidence suggests limited benefit when used prophylactically alongside active management of the third stage of labor. It is concluded that tranexamic acid represents a promising strategy; however, its preventive use should be individualized, integrated into institutional protocols, and supported by careful risk assessment.

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Referências

ACOG. Practice Bulletin No. 183: Postpartum Hemorrhage. Obstetrics & Gynecology, v. 130, n. 4, p. e168–e186, 2017. Available at: https://doi.org/10.1097/AOG.0000000000002351. Accessed on: Mar 9, 2026.

BRENNER, A. et al. Tranexamic acid for post-partum haemorrhage: what, who and when. Best Practice & Research Clinical Obstetrics & Gynaecology, v. 61, p. 66–74, 2019. Available at: https://doi.org/10.1016/j.bpobgyn.2019.04.001. Accessed on: Mar 9, 2026.

ESCOBAR, M. F. et al. FIGO recommendations on the management of postpartum hemorrhage 2022. International Journal of Gynecology & Obstetrics, v. 157, Suppl. 1, p. 3–50, 2022. DOI: 10.1002/ijgo.14116. Available at: https://doi.org/10.1002/ijgo.14116. Accessed on: Mar 9, 2026.

PACHECO, L. D. et al. Tranexamic Acid to Prevent Obstetrical Hemorrhage after Cesarean Delivery. The New England Journal of Medicine, v. 388, p. 1365–1375, 2023. DOI: 10.1056/NEJMoa2207419. Available at: https://doi.org/10.1056/NEJMoa2207419. Accessed on: Mar 9, 2026.

ROHWER, C. et al. Tranexamic acid for preventing postpartum haemorrhage after caesarean section. Cochrane Database of Systematic Reviews, n. 11, CD016278, 2024. DOI: 10.1002/14651858.CD016278. Available at: https://doi.org/10.1002/14651858.CD016278. Accessed on: Mar 11, 2026.

ROHWER, C. et al. Tranexamic acid for preventing postpartum haemorrhage after vaginal birth. Cochrane Database of Systematic Reviews, n. 1, CD007872, 2025. DOI: 10.1002/14651858.CD007872.pub4. Available at: https://doi.org/10.1002/14651858.CD007872.pub4. Accessed on: Mar 7, 2026.

SENTILHES, L. et al. Tranexamic Acid for the Prevention of Blood Loss after Vaginal Delivery. The New England Journal of Medicine, v. 379, p. 731–742, 2018. DOI: 10.1056/NEJMoa1800942. Available at: https://doi.org/10.1056/NEJMoa1800942. Accessed on: Mar 9, 2026.

SENTILHES, L. et al. Tranexamic Acid for the Prevention of Blood Loss after Cesarean Delivery. The New England Journal of Medicine, v. 384, p. 1623–1634, 2021. DOI: 10.1056/NEJMoa2028788. Available at: https://doi.org/10.1056/NEJMoa2028788. Accessed on: Mar 5, 2026.

WOMAN TRIAL COLLABORATORS. 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, v. 389, n. 10084, p. 2105–2116, 2017. DOI: 10.1016/S0140-6736(17)30638-4. Available at: https://doi.org/10.1016/S0140-6736(17)30638-4. Accessed on: Mar 12, 2026.

WORLD HEALTH ORGANIZATION. WHO recommendation on tranexamic acid for the treatment of postpartum haemorrhage. Geneva: World Health Organization, 2017.

Available at: https://www.who.int/publications/i/item/WHO-RHR-17.21. Accessed on: Mar 12, 2026.

WORLD HEALTH ORGANIZATION. Postpartum haemorrhage. Geneva: World Health Organization, 2023. Available at: https://www.who.int/news-room/fact-sheets/detail/postpartum-haemorrhage. Accessed on: Mar 12, 2026.

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Publicado

2026-05-10

Como Citar

ALEXANDRE, Kellen de Pícoli et al. EFFICACY OF TRANEXAMIC ACID IN THE PREVENTION OF POSTPARTUM HEMORRHAGE: A NARRATIVE LITERATURE REVIEW. Periódicos Brasil. Pesquisa Científica, Macapá, Brasil, v. 5, n. 3, p. 512–521, 2026. DOI: 10.36557/2674-9432.2026v5n3p512-521. Disponível em: https://periodicosbrasil.emnuvens.com.br/revista/article/view/982. Acesso em: 12 maio. 2026.