{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T03:47:39Z","timestamp":1782186459474,"version":"3.54.5"},"reference-count":21,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T00:00:00Z","timestamp":1781481600000},"content-version":"vor","delay-in-days":14,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Obstet and Gynaecol"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      Postpartum hemorrhage (PPH) remains a major cause of maternal morbidity despite standard active management of the third stage of labor. Evidence regarding the prophylactic use of tranexamic acid (TA) after vaginal delivery, particularly according to PPH risk stratification, is limited. This study aimed to evaluate the efficacy of prophylactic intravenous tranexamic acid administered after vaginal delivery in reducing postpartum blood loss. The\n                      <jats:italic>primary outcome<\/jats:italic>\n                      was measured blood loss during the third and fourth stages of labor.\n                      <jats:italic>Secondary outcomes<\/jats:italic>\n                      included the incidence of uterine atony, need for blood transfusion, requirement for additional uterotonics, and treatment\u2010related adverse effects, assessed separately in low\u2010 and high\u2010risk PPH groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>\n                      This double\u2010blind, prospective, randomized controlled trial included 480 singleton pregnant women aged 18\u201345\u2009years who delivered at \u2265\u200934\u2009weeks of gestation. Participants were first stratified according to postpartum hemorrhage (PPH) risk as low\u2010risk (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009240) or high\u2010risk (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009240). Within each risk group, women were randomly assigned in a 1:1 ratio\n                      <jats:italic>to receive either<\/jats:italic>\n                      intravenous tranexamic acid (1\u2009g) or placebo after vaginal delivery (120 participants per treatment arm in each risk group).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In low\u2010risk patients, both the collected blood volume and estimated blood loss were significantly lower in the tranexamic acid (TA) group compared with placebo. In high\u2010risk patients, TA administration was associated with significantly reduced collected blood volume and estimated blood loss, as well as a lower incidence of uterine atony. In addition, the need for blood transfusion and additional uterotonic use was lower in patients receiving TA, particularly in the high\u2010risk group. No clinically significant differences were observed in laboratory safety parameters, including D\u2010dimer levels.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Prophylactic tranexamic acid administration after vaginal delivery significantly reduced postpartum blood loss compared with placebo. While TA was effective in reducing blood loss in both low\u2010 and high\u2010risk patients, a significant reduction in uterine atony was observed only in the high\u2010risk group. No major adverse effects related to TA were identified, suggesting that TA was well tolerated in the study population. Major maternal morbidity outcomes were not assessed in this study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jog.70372","type":"journal-article","created":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T04:51:18Z","timestamp":1781585478000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy of Prophylactic Tranexamic Acid Use After Vaginal Delivery According to Postpartum Hemorrhage Risk: Randomized, Double\u2010Blind, Placebo\u2010Controlled Trial"],"prefix":"10.1111","volume":"52","author":[{"given":"Oznur","family":"Tosun","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Antalya City Hospital  Antalya Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3365-8899","authenticated-orcid":false,"given":"Nefise Nazl\u0131","family":"Yenigul","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Ac\u0131badem Bursa Hospital  Bursa Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4574-230X","authenticated-orcid":false,"given":"Elif Y\u00fcce","family":"Bilgin","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Ba\u015fak\u015fehir \u00c7am Ve Sakura City Hospital  \u0130stanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2697-7501","authenticated-orcid":false,"given":"Burcu","family":"Dincgez","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Health Sciences School of Medicine Bursa Yuksek Ihtisas Research and Training Hospital  Bursa Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,15]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(94)90047-7"},{"issue":"1","key":"e_1_2_10_3_1","first-page":"53","article-title":"El\u2010Menia Air Inflated Balloon in Controlling Atonic Post Partum Hemorrhage","volume":"1","author":"Soltan M. 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