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Postpartum HemorrhagePhase 3TRAAP2NCT03431805

TRAnexamic Acid for Preventing Postpartum Hemorrhage Following a Cesarean Delivery

A Phase 3 study testing Tranexamic Acid Injectable Solution and Sodium Chloride 0.9% in people with Postpartum Hemorrhage, run by University Hospital, Bordeaux at 26 sites in France.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The aim is to assess the impact of tranexamic acid (TXA) for preventing postpartum hemorrhage (PPH) following a cesarean section (CS). Read more about this study

Who is it for?
Ages 18 to 64 years, women only
Conditions the study is for
Postpartum Hemorrhage
What is being tested?
Tranexamic Acid Injectable Solution and Sodium Chloride 0.9%
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
4,574 participants
Where
26 sitesFrance
Study dates
3 Mar 2018to 8 Apr 2020
Phase
Phase 3
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 64 years
  • Women only
  • No healthy volunteers
  • Adult

Who may be able to join

  • : adult women admitted for a cesarean delivery before or during labor, at a term ≥ 34 weeks,
  • hemoglobin level at the last blood sample >9g/dl,
  • available blood test for Hb and Ht within one week before caesarean delivery,
  • informed signed consent

Who cannot join

  • previous thrombotic event or preexisting pro-thrombotic disease,
  • epileptic state or history of seizures,
  • presence of any chronic or active cardiovascular disease outside hypertension,
  • any chronic or active renal disease and chronic or active liver disease at risk thrombotic or hemorrhagic, autoimmune disease,
  • sickle cell disease,
  • placenta praevia,
Show all 18Show fewer
  • placenta accreta/increta/percreta,
  • abruption placentae,
  • eclampsia,
  • HELLP syndrome,
  • significant hemorrhage before cesarean section
  • in utero fetal death,
  • administration of low-molecular-weight heparin or antiplatelet agents during the week before delivery,
  • planned general anesthesia,
  • hypersensitivity to tranexamic acid or concentrated hydrochloric acid,
  • instrumental extraction failure,
  • multiple pregnancy with vaginal delivery of the first child,
  • poor understanding of the French language.

Trial locations and contacts

26 sites in 1 country.

26 sites in 1 country

France26 sites
  • CHU Angers

    Angers, 49033

  • CHU Jean Minjoz

    Besançon, 25000

  • CHU Bordeaux

    Bordeaux, 33076

  • CHRU Côte de Nacre

    Caen, 14033

  • CHU Estain

    Clermont-Ferrand, 63001

  • Centre Hospitalier Intercommunal de Créteil

    Créteil

  • Hôpital Saint Joseph Marseille

    Marseille, 13008

  • Hopital Nord

    Marseille, 13915

  • CHU de Montpellier

    Montpellier, 34295

  • CHRU de Nancy

    Nancy, 54000

  • CHU Nantes

    Nantes, 44093

  • CHU Nîmes

    Nîmes, 30900

  • Hôpital Trousseau

    Paris, 75012

  • Hôpital Saint Joseph Paris

    Paris, 75014

  • Maternité de Port-Royal Paris

    Paris, 75014

  • Hôpital universitaire Necker-Enfants malades

    Paris, 75015

  • Hôpital universitaire Robert Debré

    Paris, 75019

  • Hôpital universitaire Kremlin-Bicètre

    Paris, 94270

  • CH de Pau

    Pau

  • Centre Hospitalier Intercommunal Poissy-Saint Germain

    Poissy, 78303

  • CHU Rennes

    Rennes, 35033

  • CHU Charles Nicolle

    Rouen, 76000

  • CHU Saint Etienne

    Saint-Etienne, 42270

  • CHU Strasbourg

    Strasbourg, 67098

  • Hôpital Paule de Viguier CHU Toulouse

    Toulouse, 31059

  • CHU Tours

    Tours, 37044

Other trials in France

About this study

Official title: TRAnexamic Acid for Preventing Postpartum Hemorrhage Following a Cesarean Delivery :a Multicenter Randomised, Double Blind Placebo Controlled Trial (TRAAP2)

The aim is to assess the impact of tranexamic acid (TXA) for preventing postpartum hemorrhage (PPH) following a cesarean section (CS).

Read the detailed description

Regarding the prevention of PPH, recent randomized controlled trials (RCTs) of unclear quality have suggested that TXA may reduce blood loss and maternal morbidity, while a Cochrane Collaboration review has concluded, that "TXA (in addition to uterotonic medications) decreases postpartum blood loss and prevents PPH and blood transfusions following vaginal birth and CS in women at low risk of PPH based on studies of mixed quality. Further investigations are needed on efficacy and safety of this regimen for preventing PPH.

Treatment, that is a 10-mL blinded vial of the study drug (either 1g TXA or placebo according to the randomization sequence), will be administered intravenously to the participant women during the third stage of labor of cesarean delivery.

The follow-up visit will take place in the postpartum ward of the maternity unit, on D2 postpartum. This stage will include a venous blood sample to measure plasma concentrations of Hb and Ht, urea and creatinemia, prothrombin time (PT), active prothrombin time (aPTT), aspartate and alanine transaminase, total bilirubin and fibrinogen, and the completion of a self-questionnaire about satisfaction by the women, as well as the assessment of the adverse events.

At 8 weeks postpartum, a self-questionnaire assessing psychological status and well-being will be sent to the women. At 12 weeks postpartum, all participants will be contacted by phone to assess the incidence of thrombotic and any other significant events.

Being tested
Tranexamic Acid Injectable Solution, Sodium Chloride 0.9%
Keywords
Randomized, double blind placebo controlled trial, prevention, tranexamic acid, postpartum hemorrhage, cesarean
Medical subject headings
Postpartum Hemorrhage

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Tranexamic Acid Injectable SolutionDrug

    After the routine and prophylactic administration of a uterotonic , the intervention will be the IV administration of a 10-ml blinded ampoule of the study drug (either TXA or placebo according to the randomisation sequence) to the woman within 3 minutes after birth, slowly (over 30-60 seconds), once the cord has been clamped.

  • Sodium Chloride 0.9%Drug

    After a routine and prophylactic administration of a uterotonic , the intervention will be the IV administration of a 10-ml blinded ampoule of the study drug (either TXA or placebo according to the randomisation sequence) to the patient within 3 minutes afterbirth), slowly (over 30-60 seconds), once the cord has been clamped.

Study groups in NCT03431805
Study groupRoleWhat they receive
Tranexamic acidExperimentalintravenous administration of 10-mL of tranexamic acid (EXACYL® 1 g/10 ml I.V., solution injectable)
Receives: Drug: Tranexamic Acid Injectable Solution
Chloride solutionPlacebo comparatorsodium intravenous administration of 10-mL of chloride solution (0.9% -10mL).
Receives: Drug: Sodium Chloride 0.9%

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. postpartum hemorrhage

    Incidence of PPH defined by a calculated blood loss > 1000mL [Calculated estimated blood loss = estimated blood volume × (preoperative Ht - postoperative Ht)/preoperative Ht (where estimated blood volume (mL) = weight (Kg) × 85)] or red blood cell transfusion up to day 2 postpartum. Preoperative Ht will be the most recent Ht within one week before delivery. Postoperative Ht will be measured at D2

    Measured: day 2

Secondary outcomes (43)
  1. mean calculated blood loss > 500mL

    Measured: day 2

  2. mean calculated blood loss > 1500mL

    Measured: day 2

  3. total mean calculated blood loss

    Measured: day 2

  4. mean gravimetrically estimated blood loss

    by measuring the suction volume and swab weight; proportion of women requiring supplementary uterotonic treatment including sulprostone

    Measured: 6 hours

  5. incidence of postpartum transfusion

    Measured: day 2

  6. Mean or median number of units of red blood cells transfused

    Measured: day 2

  7. incidence of arterial embolisation or emergency surgery for PPH

    Measured: 3 months

  8. mean peripartum change in haemoglobin

    difference between the most recent Hb within one week before delivery and at day 2 postpartum

    Measured: day 2

  9. mean peripartum change in hematocrit

    difference between the most recent Ht within one week before delivery and at day 2 postpartum

    Measured: day 2

  10. heart rate

    bpm

    Measured: 15, 30, 45, 60 and 120 minutes after delivery

  11. diastolic blood pressure

    mmHg

    Measured: 15, 30, 45, 60 and 120 minutes after delivery

  12. systolic blood pressure

    mmHg

    Measured: 15, 30, 45, 60 and 120 minutes after delivery

  13. number of participants with nausea reported by caregivers

    Measured: 6 hours

  14. number of participants with vomiting reported by caregivers

    Measured: 6 hours

  15. number of participants with phosphenes reported by caregivers

    Measured: 6 hours

  16. number of participants with dizziness reported by caregivers

    Measured: 6 hours

  17. creatinemia

    micromol/L

    Measured: day 2

  18. urea

    g/L

    Measured: day 2

  19. prothrombin time (PT)

    %

    Measured: day 2

  20. aspartate transaminase

    IU/L

    Measured: day 2

  21. alanine transaminase

    IU/L

    Measured: day 2

  22. total bilirubin

    micromol/L

    Measured: day 2

  23. total fibrinogen

    g/L

    Measured: day 2

  24. number of participants with deep venous thrombosis confirmed by paraclinical exams

    Measured: within twelve weeks after the delivery

  25. number of participants with pulmonary embolism confirmed by paraclinical exams

    Measured: within twelve weeks after the delivery

  26. number of participants with myocardial infarction confirmed by paraclinical exams

    Measured: within twelve weeks after the delivery

  27. number of participants with any thrombotic event confirmed by paraclinical exams

    Measured: within twelve weeks after the delivery

  28. seizure

    Measured: within twelve weeks after the delivery

  29. renal failure

    defined by the need for dialysis

    Measured: within twelve weeks after the delivery

  30. women's satisfaction

    assessed by a self-administered questionnaire

    Measured: day 2 and weeks 8 postpartum

  31. Provider-assessed clinically significant PPH

    Measured: day 2

  32. Hb drop > 2g/DL

    Measured: day 2

  33. Active prothrombin time (aPTT)

    Measured: day 2

  34. aspartate transaminase > 2N

    Measured: day 2

  35. alanine transaminase > 2N (day 2)

    Measured: day 2

  36. gravimetrically estimated blood loss > 500mL

    Measured: day 2

  37. gravimetrically estimated blood loss > 1000 mL

    Measured: day 2

  38. Shock

    Measured: day 2

  39. Transfer to Intensive Care Unit

    Measured: twelve weeks after delivery

  40. Death from any cause

    Measured: 42 days postpartum

  41. supplementary uterotonic treatment

    proportion of women requiring supplementary uterotonic treatment

    Measured: day 2

  42. iron sucrose perfusion

    incidence of iron sucrose perfusion

    Measured: discharge from hospital

  43. mean gravimetrically estimated blood loss

    Measured: at the end of the cesarean delivery

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted13 Feb 2018
  2. Study start3 Mar 2018
  3. Primary completion14 Jan 2020
  4. Study completion8 Apr 2020

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 3
Primary purpose
Prevention
Allocation
Randomised
Intervention model
Parallel groups
Masking
Double blind
Who is masked
Participant, Investigator
Enrolment
4,574 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03431805
Sponsor's protocol ID
CHUBX 2015/41
Other IDs
2017-001144-36, 2017
Acronym
TRAAP2
Status last verified
Apr 2020
First submitted
30 Jan 2018
Last updated
12 May 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • Sentilhes L, Benard A, Madar H, Froeliger A, Petit S, Deneux-Tharaux C; TRAAP2 study group. Tranexamic acid for reduction of blood loss after Caesarean delivery: a cost-effectiveness analysis of the TRAAP2 trial. Br J Anaesth. 2023 Nov;131(5):893-900. doi: 10.1016/j.bja.2023.07.028. Epub 2023 Sep 9.

    PubMed 37690946
  • Sentilhes L, Senat MV, Le Lous M, Winer N, Rozenberg P, Kayem G, Verspyck E, Fuchs F, Azria E, Gallot D, Korb D, Desbriere R, Le Ray C, Chauleur C, de Marcillac F, Perrotin F, Parant O, Salomon LJ, Gauchotte E, Bretelle F, Sananes N, Bohec C, Mottet N, Legendre G, Letouzey V, Haddad B, Vardon D, Madar H, Mattuizzi A, Daniel V, Regueme S, Roussillon C, Benard A, Georget A, Darsonval A, Deneux-Tharaux C; Groupe de Recherche en Obstetrique et Gynecologie. Tranexamic Acid for the Prevention of Blood Loss after Cesarean Delivery. N Engl J Med. 2021 Apr 29;384(17):1623-1634. doi: 10.1056/NEJMoa2028788.

    PubMed 33913639
  • Sentilhes L, Daniel V, Deneux-Tharaux C; TRAAP2 Study Group and the Groupe de Recherche en Obstetrique et Gynecologie (GROG). TRAAP2 - TRAnexamic Acid for Preventing postpartum hemorrhage after cesarean delivery: a multicenter randomized, doubleblind, placebo- controlled trial - a study protocol. BMC Pregnancy Childbirth. 2020 Jan 31;20(1):63. doi: 10.1186/s12884-019-2718-4.

    PubMed 32005192

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Tranexamic Acid Injectable Solution and Sodium Chloride 0.9% in people with Postpartum Hemorrhage, run by University Hospital, Bordeaux at 26 sites in France.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 18 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 12 May 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 26 sites in France. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

postpartum hemorrhage (time frame: day 2). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03431805, which also lists 3 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 12 May 2026.

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