What do systematic reviews say?

Standard care plus IV tranexamic acid vs placebo or usual care

Standard care plus IV tranexamic acid showed no clear difference in maternal mortality due to bleeding compared with placebo or standard care alone (moderate certainty).

• Antifibrinolytic drugs for treating primary postpartum haemorrhage 2018 · Cochrane Headline outcomes only
  RR 0.81 [0.65, 1]
  2 studies · 20172 participants
  Moderate

Standard care plus IV tranexamic acid vs placebo or usual care

Standard care plus IV tranexamic acid showed no clear difference in maternal mortality (all causes) compared with placebo or standard care alone (moderate certainty).

• Antifibrinolytic drugs for treating primary postpartum haemorrhage 2018 · Cochrane Headline outcomes only
  RR 0.88 [0.74, 1.05]
  2 studies · 20172 participants
  Moderate

Standard care plus IV tranexamic acid vs placebo or usual care

Standard care plus IV tranexamic acid showed no clear difference in serious maternal morbidity (any) compared with placebo or standard care alone (high certainty).

• Antifibrinolytic drugs for treating primary postpartum haemorrhage 2018 · Cochrane Headline outcomes only
  RR 0.99 [0.83, 1.19]
  1 study · 20015 participants
  High

Standard care plus IV tranexamic acid vs placebo or usual care

Standard care plus IV tranexamic acid may leads to lower blood loss 500 mL or more after randomisation compared with placebo or standard care alone (low certainty).

• Antifibrinolytic drugs for treating primary postpartum haemorrhage 2018 · Cochrane Headline outcomes only
  RR 0.5 [0.27, 0.93]
  1 study · 151 participants
  Low

Standard care plus IV tranexamic acid vs placebo or usual care

Standard care plus IV tranexamic acid showed no clear difference in blood transfusion (any) compared with placebo or standard care alone (moderate certainty).

• Antifibrinolytic drugs for treating primary postpartum haemorrhage 2018 · Cochrane Headline outcomes only
  RR 1 [0.97, 1.03]
  2 studies · 20167 participants
  Moderate

Standard care plus IV tranexamic acid vs placebo or usual care

Standard care plus IV tranexamic acid showed no clear difference in surgical intervention to control bleeding: Hysterectomy compared with placebo or standard care alone (high certainty).

• Antifibrinolytic drugs for treating primary postpartum haemorrhage 2018 · Cochrane Headline outcomes only
  RR 0.95 [0.81, 1.12]
  1 study · 20017 participants
  High

Standard care plus IV tranexamic acid vs placebo or usual care

Standard care plus IV tranexamic acid showed no clear difference in side effects of the intervention: Any maternal vascular occlusive… compared with placebo or standard care alone (moderate certainty).

• Antifibrinolytic drugs for treating primary postpartum haemorrhage 2018 · Cochrane Headline outcomes only
  RR 0.88 [0.54, 1.43]
  1 study · 20018 participants
  Moderate

Interventions (vitamin B1, mefenamic acid, tranexamic acid) vs placebo or active comparators (desmopressin, sodium diclofenac, flavonoids)

The review found no eligible studies for this question.

• Interventions to prevent or treat heavy menstrual bleeding or pain associated with intrauterine‐device use 2022 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Interventions (vitamin B1, mefenamic acid, tranexamic acid) vs placebo or active comparators (desmopressin, sodium diclofenac, flavonoids)

• Interventions to prevent or treat heavy menstrual bleeding or pain associated with intrauterine‐device use 2022 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 38 participants
  Very low

Interventions (vitamin B1, mefenamic acid, tranexamic acid) vs placebo or active comparators (desmopressin, sodium diclofenac, flavonoids)

It is very uncertain whether interventions (vitamin B1, mefenamic acid, tranexamic acid) changes side effects: gastrointestinal disturbances (diarrhoea, lower… compared with placebo or active comparators (desmopressin, sodium diclofenac,… (very low certainty).

• Interventions to prevent or treat heavy menstrual bleeding or pain associated with intrauterine‐device use 2022 · Cochrane Headline outcomes only
  OR 4.69 [1.2, 18.44]
  1 study · 38 participants
  Very low

Interventions (vitamin B1, mefenamic acid, tranexamic acid) vs placebo or active comparators (desmopressin, sodium diclofenac, flavonoids)

• Interventions to prevent or treat heavy menstrual bleeding or pain associated with intrauterine‐device use 2022 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 100 participants
  Low
• Interventions to prevent or treat heavy menstrual bleeding or pain associated with intrauterine‐device use 2022 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 24 participants
  Very low

Interventions (vitamin B1, mefenamic acid, tranexamic acid) vs placebo or active comparators (desmopressin, sodium diclofenac, flavonoids)

• Interventions to prevent or treat heavy menstrual bleeding or pain associated with intrauterine‐device use 2022 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 100 participants
  Low
• Interventions to prevent or treat heavy menstrual bleeding or pain associated with intrauterine‐device use 2022 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 110 participants
  Low

Interventions (vitamin B1, mefenamic acid, tranexamic acid) vs placebo or active comparators (desmopressin, sodium diclofenac, flavonoids)

• Interventions to prevent or treat heavy menstrual bleeding or pain associated with intrauterine‐device use 2022 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 100 participants
  Low
• Interventions to prevent or treat heavy menstrual bleeding or pain associated with intrauterine‐device use 2022 · Cochrane Headline outcomes only
  no estimate extracted
  4 studies · 290 participants
  Very low

Interventions (vitamin B1, mefenamic acid, tranexamic acid) vs placebo or active comparators (desmopressin, sodium diclofenac, flavonoids)

Interventions (vitamin B1, mefenamic acid, tranexamic acid) showed no clear difference in side effects: headache compared with placebo or active comparators (desmopressin, sodium diclofenac,… (low certainty).

• Interventions to prevent or treat heavy menstrual bleeding or pain associated with intrauterine‐device use 2022 · Cochrane Headline outcomes only
  OR 0.58 [0.18, 1.92]
  1 study · 100 participants
  Low

Interventions (vitamin B1, mefenamic acid, tranexamic acid) vs placebo or active comparators (desmopressin, sodium diclofenac, flavonoids)

Interventions (vitamin B1, mefenamic acid, tranexamic acid) showed no clear difference in side effects: vomiting compared with placebo or active comparators (desmopressin, sodium diclofenac,… (low certainty).

• Interventions to prevent or treat heavy menstrual bleeding or pain associated with intrauterine‐device use 2022 · Cochrane Headline outcomes only
  OR 0.74 [0.25, 2.18]
  1 study · 100 participants
  Low

Interventions (vitamin B1, mefenamic acid, tranexamic acid) vs placebo or active comparators (desmopressin, sodium diclofenac, flavonoids)

• Interventions to prevent or treat heavy menstrual bleeding or pain associated with intrauterine‐device use 2022 · Cochrane Headline outcomes only
  no estimate extracted
  1 participants
  GRADE not reported

Interventions (vitamin B1, mefenamic acid, tranexamic acid) vs placebo or active comparators (desmopressin, sodium diclofenac, flavonoids)

• Interventions to prevent or treat heavy menstrual bleeding or pain associated with intrauterine‐device use 2022 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 110 participants
  Low
• Interventions to prevent or treat heavy menstrual bleeding or pain associated with intrauterine‐device use 2022 · Cochrane Headline outcomes only
  no estimate extracted
  2 studies · 152 participants
  Low

Interventions (vitamin B1, mefenamic acid, tranexamic acid) vs placebo or active comparators (desmopressin, sodium diclofenac, flavonoids)

The review found no eligible studies for this question.

• Interventions to prevent or treat heavy menstrual bleeding or pain associated with intrauterine‐device use 2022 · Cochrane Headline outcomes only
  no estimate extracted
  Studies not reported
  No studies found

Interventions (vitamin B1, mefenamic acid, tranexamic acid) vs placebo or active comparators (desmopressin, sodium diclofenac, flavonoids)

• Interventions to prevent or treat heavy menstrual bleeding or pain associated with intrauterine‐device use 2022 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 94 participants
  Low
• Interventions to prevent or treat heavy menstrual bleeding or pain associated with intrauterine‐device use 2022 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 38 participants
  Very low

Antifibrinolytic therapy (tranexamic acid or epsilon aminocaproic acid) vs Placebo, no intervention or usual care (with or without placebo)

The review found no eligible studies for this question.

• Antifibrinolytic therapy for preventing oral bleeding in patients with haemophilia or Von Willebrand disease… 2019 · Cochrane All outcomes
  This outcome was not reported in either of the trials.
  0 studies
  No studies found