Tranexamic acid for the prevention of postpartum bleeding: Protocol for a systematic review and individual patient data meta-analysis

Background: Tranexamic acid (TXA) reduces the risk of death and is recommended as a treatment for women with severe postpartum bleeding. There hope that giving TXA shortly before or immediately after birth could prevent Extending use to harmful bleeding improve outcomes millions women; however, we must carefully consider balance benefits potential harms. This article describes protocol systematic review individual patient data (IPD) meta-analysis assess effectiveness safety preventing bleeding, explore how effects vary by underlying other characteristics. Methods: We will search prospectively registered, randomised controlled trials involving 500 patients more assessing in birth. Two authors extract bias. IPD be sought from eligible trials. Primary life-threatening thromboembolic events. one-stage model analyse data. Subgroup analyses conducted whether varies risk, type birth, maternal haemoglobin (Hb), timing TXA. Conclusions: address important clinical questions about prevention cannot answered reliably using aggregate inform decision who treat. PROSPERO registration: CRD42022345775