Sentilhes L, Sénat MV, Le Lous M, et al. - Researchers conducted this multicenter, double-blind, randomized, controlled trial to evaluate the effectiveness of tranexamic acid as a prophylactic for postpartum blood loss after cesarean delivery. Women undergoing cesarean delivery before or during labor at 34 or more gestational weeks were assigned to receive an intravenously administered prophylactic uterotonic agent and either tranexamic acid (1 g) or placebo. Of the 4,551 women who were randomly assigned, 4,431 had a caesarean delivery, with 4,153 (93.7%) of them having primary outcome results. Tranexamic acid treatment resulted in a significantly lower incidence of calculated estimated blood loss greater than 1,000 ml or red-cell transfusion by day 2 than placebo in women who had cesarean delivery and received prophylactic uterotonic agents, but it did not result in a lower incidence of hemorrhage-related secondary clinical outcomes.