{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T03:30:18Z","timestamp":1762918218539,"version":"3.40.5"},"reference-count":30,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2021,3,24]],"date-time":"2021-03-24T00:00:00Z","timestamp":1616544000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Postpartum hemorrhage (PPH) is responsible for nearly one quarter of maternal deaths. A 2017 multicountry trial found that incorporating tranexamic acid (TXA) into the PPH management package was effective in reducing maternal death due to bleeding.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To systematically review studies assessing the cost\u2010effectiveness of tranexamic acid for PPH treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Search strategy<\/jats:title><jats:p>Nine databases were searched using variations of keywords \u2018tranexamic acid\u2019, \u2018postpartum hemorrhage\u2019 and \u2018cost effectiveness\u2019.<\/jats:p><\/jats:sec><jats:sec><jats:title>Selection criteria<\/jats:title><jats:p>Eligible studies were any type of economic or effectiveness evaluation studies on tranexamic acid for treating women with PPH.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data collection and analysis<\/jats:title><jats:p>Two reviewers independently screened citations and extracted data on cost effectiveness measures. Quality was assessed using the Consensus on Health Economic Criteria list.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main results<\/jats:title><jats:p>Four studies were included, of which two were abstracts. Three studies concluded that early administration of TXA was cost\u2010saving or cost\u2010effective. One abstract reported TXA was not cost\u2010effective in the USA unless the probability of death due to hemorrhage is higher.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Available evidence (four studies in three countries) suggests that this life\u2010saving intervention may be below willingness to pay thresholds (cost\u2010effective) or cost saving. Further studies conducted in different populations and settings are needed to inform health policy decision\u2010making to reduce PPH\u2010associated morbidity and mortality.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ijgo.13654","type":"journal-article","created":{"date-parts":[[2021,2,23]],"date-time":"2021-02-23T21:03:14Z","timestamp":1614114194000},"page":"331-344","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["The cost\u2010effectiveness of tranexamic acid for treatment of postpartum hemorrhage: A systematic review"],"prefix":"10.1002","volume":"155","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7670-1116","authenticated-orcid":false,"given":"Samia","family":"Aziz","sequence":"first","affiliation":[{"name":"Maternal, Child and Adolescent Health Program Burnet Institute Melbourne Vic. Australia"},{"name":"School of Population and Global Health The University of Melbourne Melbourne Vic. Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shania","family":"Rossiter","sequence":"additional","affiliation":[{"name":"Maternal, Child and Adolescent Health Program Burnet Institute Melbourne Vic. Australia"},{"name":"School of Population and Global Health The University of Melbourne Melbourne Vic. Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caroline S. E.","family":"Homer","sequence":"additional","affiliation":[{"name":"Maternal, Child and Adolescent Health Program Burnet Institute Melbourne Vic. Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alyce N.","family":"Wilson","sequence":"additional","affiliation":[{"name":"Maternal, Child and Adolescent Health Program Burnet Institute Melbourne Vic. Australia"},{"name":"Nossal Institute for Global Health Melbourne School of Population and Global Health University of Melbourne Melbourne Vic. Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liz","family":"Comrie\u2010Thomson","sequence":"additional","affiliation":[{"name":"Maternal, Child and Adolescent Health Program Burnet Institute Melbourne Vic. Australia"},{"name":"School of Public Health and Preventive Medicine Monash University Melbourne Vic. Australia"},{"name":"Faculty of Medicine and Health Sciences Ghent University Ghent Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nick","family":"Scott","sequence":"additional","affiliation":[{"name":"Maternal, Child and Adolescent Health Program Burnet Institute Melbourne Vic. Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joshua P.","family":"Vogel","sequence":"additional","affiliation":[{"name":"Maternal, Child and Adolescent Health Program Burnet Institute Melbourne Vic. Australia"},{"name":"Nossal Institute for Global Health Melbourne School of Population and Global Health University of Melbourne Melbourne Vic. Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,3,24]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"World Health Organization.Trends in maternal mortality: 1990 to 2015: estimates by WHO UNICEF UNFPA World Bank Group and the United Nations Population Division. [WHO website] 2016.https:\/\/www.who.int\/reproductivehealth\/publications\/maternal\u2010mortality\u20102000\u20102017\/en\/. Accessed June 29 2020."},{"key":"e_1_2_10_3_1","unstructured":"World Health Organization.Maternal Mortality Fact Sheet. [WHO website].2019.https:\/\/apps.who.int\/iris\/bitstream\/handle\/10665\/112318\/WHO_RHR_14.06_eng.pdf;sequence=1. 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