{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T15:55:32Z","timestamp":1775836532197,"version":"3.50.1"},"reference-count":31,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,3,15]],"date-time":"2024-03-15T00:00:00Z","timestamp":1710460800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2024,3,15]],"date-time":"2024-03-15T00:00:00Z","timestamp":1710460800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100018822","name":"Western Sydney University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100018822","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Australian J Rural Health"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Primary postpartum haemorrhage causes approximately 25% of global maternal deaths and accounts for significant maternal morbidity. While high certainty evidence demonstrates that tranexamic acid reduces comparative blood loss in postpartum haemorrhage in hospital settings, limited data exist on the specific pharmacological management of this condition in out\u2010of\u2010hospital settings, and the implications for rural communities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To determine the efficacy of oxytocin compared to tranexamic acid in women suffering postpartum haemorrhage in the out\u2010of\u2010hospital environment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A systematic review comparing evidence containing patients with postpartum haemorrhage in the out\u2010of\u2010hospital and\/or rural setting, in which oxytocin\/tranexamic acid were used. Outcome measures were comparative blood loss\/haemorrhagic shock, the need for further interventions and maternal\/neonatal morbidity\/mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>No randomised control trials have been conducted in an out\u2010of\u2010hospital environment in relation to oxytocin\/tranexamic acid. In this setting, there is no difference in outcome measures when using oxytocin compared to no intervention, or oxytocin compared to standard care. Data are lacking on the effect of tranexamic acid on the same outcome measures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Rural and out\u2010of\u2010hospital management of postpartum haemorrhage is limited by resource availability and practitioner availability, capacity and experience. In\u2010hospital evidence may lack transferability, therefore direct evidence on the efficacy of pharmacological management in these contexts is scant and requires redress.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>There is no difference in blood loss, neonatal or maternal mortality or morbidity, or need for further interventions, when using oxytocin or TXA compared to no intervention, or compared to standard care, for PPH. Further studies are needed on the efficacy of these drugs, and alternate or co\u2010drug therapies, for PPH in the out\u2010of\u2010hospital environment and rural clinical practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ajr.13103","type":"journal-article","created":{"date-parts":[[2024,3,16]],"date-time":"2024-03-16T02:37:53Z","timestamp":1710556673000},"page":"227-235","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Tranexamic acid versus oxytocin for primary postpartum Haemorrhage in the out\u2010of\u2010hospital setting: A systematic review with implications for rural practice"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-3650-9855","authenticated-orcid":false,"given":"Megan","family":"De\u00a0Silva","sequence":"first","affiliation":[{"name":"School of Health Sciences Western Sydney University  Campbelltown New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabrielle","family":"Mizzi","sequence":"additional","affiliation":[{"name":"School of Health Sciences Western Sydney University  Campbelltown New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emily","family":"Potts","sequence":"additional","affiliation":[{"name":"School of Health Sciences Western Sydney University  Campbelltown New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jayden","family":"Webb","sequence":"additional","affiliation":[{"name":"School of Health Sciences Western Sydney University  Campbelltown New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8144-4441","authenticated-orcid":false,"given":"Elizabeth","family":"Thyer","sequence":"additional","affiliation":[{"name":"School of Health Sciences Western Sydney University  Campbelltown New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5261-0677","authenticated-orcid":false,"given":"Navindhra","family":"Naidoo","sequence":"additional","affiliation":[{"name":"School of Health Sciences Western Sydney University  Campbelltown New South Wales Australia"},{"name":"Emergency Medical Sciences Cape Peninsula University of Technology  Cape Town South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,3,15]]},"reference":[{"key":"e_1_2_11_2_1","volume-title":"WHO recommendations for the prevention and treatment of postpartum haemorrhage","author":"World Health Organization","year":"2012"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.045156"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1080\/01674820400023408"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600\u20100412.2011.01119.x"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mehy.2019.109394"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/GCO.0000000000000776"},{"key":"e_1_2_11_8_1","unstructured":"World Health Organization United Nations Children's Fund United Nations Population Fund.Appropriate storage and management of oxytocin \u2013 a key commodity for maternal.2019. 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