I’M WOMAN

PPH, or severe bleeding after childbirth, kills tens of thousands of mothers every year. Factors such as anaemia, high blood pressure, an unusual placenta, or a long or difficult labour can increase the chances of women having a PPH.

In 2017, the WOMAN Trial found that TXA reduces death from bleeding and the need for surgery to control bleeding by about one third when given to women with PPH within three hours of birth.

TXA is usually given by slow IV injection, but this route of administration is a major access barrier. Recent research shows that TXA is well tolerated and rapidly absorbed after IM injection, achieving therapeutic blood levels within minutes of injection. The I’M WOMAN Trial is now generating evidence on whether giving TXA intramuscularly is as effective as giving it intravenously.

There may be fewer side effects with IM TXA because peak blood concentrations are lower than with the IV route. IM TXA also has practical advantages as it is quicker and simpler to administer.

The trial is also investigating whether giving TXA earlier, before birth, can prevent severe bleeding after childbirth.