Overview

The primary audience includes health professionals who are responsible for developing national and local health protocols (particularly those related to PPH) and those directly providing care to pregnant women and their newborns, including midwives, nurses, general medical practitioners, obstetricians, managers of maternal and child health programmes, and relevant staff in ministries of health, in all settings.

The updating of this recommendation was guided by standardized operating procedures in accordance with the process described in the WHO handbook for guideline development. A Guideline Development Group (GDG) was convened in August 2017 to review and consider the updated analysis on tranexamic acid, as well as consider other important factors in its use, such as values and preferences of stakeholders, resource requirements, cost-effectiveness, acceptability, feasibility and equity. WHO has published an updated recommendation on the use tranexamic acid for PPH treatment, which supersedes the 2012 recommendation.

Contents

• Acknowledgements
• Acronyms and abbreviations
• Executive Summary
  • Introduction
  • Target audience
  • Guideline development methods
  • Recommendation
• 1. Background
  • Rationale and objectives
  • Target audience
  • Scope of the recommendation
• 2. Methods
  • Contributors to the guideline
  • Identification of critical outcomes
  • Evidence identification and retrieval
  • Quality assessment and grading of the evidence
  • Formulation of recommendations
  • Declaration of interests by external contributors
  • Decision-making during the technical consultation
  • Document preparation
  • Peer review
• 3. Evidence and recommendation
  • A. Review Question
  • B. Assessment
• 4. Research implications
• 5. Dissemination and implementation of the recommendation
  • Recommendation dissemination and evaluation
  • Implementation considerations
• 6. Applicability issues
  • Anticipated impact on the organization of care and resources
  • Monitoring and evaluating guideline implementation
• 7. Updating the recommendation
• References
• Annex 1. External experts and WHO staff involved in the preparation of the guideline
• Annex 2. Critical and important outcomes for decision-making
• Annex 3. Summary and management of declared interests from GDG members
• Annex 4. Summary of the considerations related to the strength of the recommendations
• Annex 5. GRADE Tables

Suggested citation:

WHO recommendation on tranexamic acid for the treatment of postpartum haemorrhage. Geneva: World Health Organization; 2017. Licence: CC BY-NC-SA 3.0 IGO.

The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of WHO concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted and dashed lines on maps represent approximate border lines for which there may not yet be full agreement.

The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by WHO in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters.

All reasonable precautions have been taken by WHO to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall WHO be liable for damages arising from its use.