6/30/23, 2:19 AM TRAAP2 Pathway Feedback Search Clinical Topics Home Studies TRAAP2 TRAAP2 Disease Cesarean delivery Trial question What is the role of tranexamic acid in women undergoing Cesarean delivery? Study design Multi-center Double blinded RCT Population 4431 female patients Inclusion criteria: women undergoing Cesarean delivery at 34 gestational weeks Key exclusion criteria: previous episode of deep vein thrombosis or PE; increased risk of venous or arterial thrombosis or bleeding; history of epilepsy or seizure; prenatal Hgb level 9 g/dL in the week before delivery; autoimmune disease Interventions N=2222 tranexamic acid (intravenous administration of prophylactic uterotonic agent and 1 g tranexamic acid) N=2209 placebo (intravenous administration of prophylactic uterotonic agent and matching placebo) Primary outcome Postpartum hemorrhage 31.6 % 31.6 26.7 23.7 % 15.8 % Significant decrease 7.9 % https://web.pathway.md/studies/recJXzqro2SbR7uMq 1/2 6/30/23, 2:19 AM TRAAP2 Pathway NNT = 20 0.0 % Tranexamic acid Placebo Significant decrease in postpartum hemorrhage (26.7% vs. 31.6%; RR 0.84, 95% CI 0.75 to 0.94) Secondary outcomes No significant difference in gravimetrically estimated blood loss (689 mL vs. 719 mL; ARD -30.6, 95% CI -90.2 to 29) No significant difference in clinically significant postpartum hemorrhage according to health care provider (13.6% vs. 14.8%; RR 0.92, 95% CI 0.79 to 1.08) No significant difference in use of additional uterotonic agents for excessive bleeding (5.9% vs. 7.2%; RR 0.81, 95% CI 0.64 to 1.03) Safety outcomes No significant difference in thromboembolic events. Significant difference in vomiting or nausea in the operating room (43.0% vs. 36.3%). Conclusion In women undergoing Cesarean delivery at 34 gestational weeks, tranexamic acid was superior to placebo with respect to postpartum hemorrhage. Reference Lo c Sentilhes, Marie V S nat, Ma la Le Lous et al. Tranexamic Acid for the Prevention of Blood Loss after Cesarean Delivery. N Engl J Med. 2021 Apr 29;384(17):1623-1634. Open reference URL https://web.pathway.md/studies/recJXzqro2SbR7uMq 2/2