Innovation stops women dying from severe blood loss after childbirth

A Wellcome-funded global trial has found that tranexamic acid (TXA), a drug discovered more than 50 years ago that costs about £2 a dose, reduces maternal death from bleeding by 31% if given within three hours.

A pregnant woman in Niger being checked by a woman doctor.

The WOMAN Trial study, coordinated by the London School of Hygiene & Tropical Medicine, recruited 20,000 mothers in 193 hospitals in 21 countries. It is published today in The Lancet.

Severe bleeding after childbirth is the leading global cause of maternal death. It affects 14 million new mothers every year, and 100,000 die because of it.

Tim Knott, Senior Partner in Innovations at Wellcome, said: "Deaths of new mothers from severe blood loss happen almost exclusively in low- and middle-income countries – and the numbers are alarming.

"The WOMAN Trial team’s hugely important and incredibly ambitious study stands to make a critical difference in preventing women dying after childbirth."

TXA works by stopping blood clots from breaking down. The study also shows it reduces the need for urgent surgery to control bleeding (a laparotomy) by more than a third (36%).

The researchers found no side-effects from the drug for either mothers or breastfeeding babies.

Haleema Shakur, Associate Professor of Clinical Trials at the London School of Hygiene & Tropical Medicine and Project Director on the WOMAN Trial, said: "We now have important evidence that the early use of tranexamic acid can save women’s lives and ensure more children grow up with a mother.

“It’s safe, affordable and easy to administer, and we hope that doctors will use it as early as possible following the onset of severe bleeding after childbirth."

The history of tranexamic acid

TXA was discovered in the 1960s by a Japanese husband and wife research team, Shosuke and Utako Okamoto.

They had hoped it would reduce deaths from postpartum haemorrhage, but couldn’t persuade obstetricians to conduct a trial. The research team filmed an interview with Utako in Japan before her death, aged 98, last year.

The current study builds on previous research involving trauma patients, which showed that tranexamic acid reduced deaths due to bleeding by almost a third if given within three hours.

The trial also received funding from the UK Department of Health, through the Health Innovation Challenge Fund, and the Bill & Melinda Gates Foundation.