(Acta Obstet Gynecol Scand 2016;95:28–37)

The World Health Organization defines postpartum hemorrhage (PPH) as “blood loss from the birth canal in excess of 500 mL during the first 24 hours after delivery,” although currently there is a debate about what definition to use for PPH. PPH is responsible for about 25% of maternal deaths worldwide, and 12% of survivors will develop severe anemia. Although there are several published clinical trials of the use of tranexamic acid (TXA) in an obstetric setting, there is no consensus on its use or guidelines for management. The aim of this meta-analysis of randomized controlled trials (RCTs) was to evaluate the effectiveness of TXA in reducing blood loss when given before cesarean delivery (CD).