Tranexamic Acid for the Prevention of Blood Loss after Vaginal Delivery
New England Journal of Medicine
In women with vaginal delivery at 35+ weeks' gestation who received prophylactic oxytocin (n=3891), use of tranexamic acid (1g IV) was not associated with a statistically significant reduction in postpartum haemorrhage (8.1% v 9.8% placebo; RR 0.83; 95% CI 0.6-1.01).
European Heart Journal
This updated joint consensus document discusses the optimal antithrombotic therapy management of this patient group, considering new guidelines published since 2014, and the availability of new drugs, devices, and interventional techniques.
Cochrane Database of Systematic Reviews
Review of 13 RCTs (n=35,997) found increased prescription of prophylaxis associated with alerts and multifaceted interventions, and increased prescription of appropriate prophylaxis linked to alerts. Analysis was underpowered to assess effect on mortality and safety outcomes.
Uterotonic agents for preventing postpartum haemorrhage: a network meta‐analysis
Cochrane Database of Systematic Reviews
Analysis of 140 RCTs (n=88,947) found ergometrine (EG) + oxytocin (OX) combination, carbetocin, and misoprostol + OX were more effective for preventing postpartum haemorrhage (PPH) ≥500 mL than current standard OX. EG +OX was more effective for preventing PPH ≥1000 mL than OX.
Haemostatic therapies for acute spontaneous intracerebral haemorrhage
Cochrane Database of Systematic Reviews
Review of 12 RCTs (n=1732) was unable to draw firm conclusions about efficacy and safety of antifibrinolytic drugs for acute spontaneous intracerebral haemorrhage (ICH), and clotting factors vs. fresh frozen plasma for acute spontaneous ICH associated with anticoagulant drug use.
The above records have been identified by UKMi and feature in the NICE Medicines Awareness Service. Further details on this service can be found at:
http://www.evidence.nhs.uk/about-evidence-services/content-and-sources/medicines-information/new-medicines-awareness-services