Tranexamic acid to prevent post-partum haemorrhage

Abstract

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"Only Women Bleed" - Alice Cooper, 1975

Whilst the title of the song made famous by Alice Cooper in 1975 does not exactly hold true, it is well recognised in the field of haematology that women represent by far the predominant gender in bleeding investigations, and also within bleeding registries. For example, in our own local Westmead database registry, now totalling over 6,000 entries, the ratio of female:male representation is almost 2:1. Similarly, in the Australian Bleeding Disorders Registry (ABDR)1, the female:male ratio in the von Willebrand disease category is 1.6:1.0. It is not so much that bleeding disorders are more prevalent in females than males. Indeed, for haemophilia A and haemophilia B, at least, the reverse is true, since these reflect X-linked disorders. Irrespectively, more women than men will require medical attention because of bleeding challenges2. The main reason women are "over-represented" within "bleeding" categories is that they carry a higher risk of haemostatic challenge. The main haemorrhagic risks unique to women are menstruation and child-birth. [ ... ]