# WOMAN-2 trial (tranexamic acid in women with anaemia)

Study · id `maternal:woman-2-trial` · Maternal & Newborn Atlas · release `c7fb95f1d15a7d13` (public)

> General information from published sources, not medical advice, and not reviewed by clinicians. Check the cited source before relying on anything here.

The atlas's own text and curation may be reused under Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0, https://creativecommons.org/licenses/by-nc/4.0/): credit the atlas, and do not use it commercially. See the atlas About page. Text quoted from a source stays under that source's own terms, given as the source's reuse\_basis. The atlas's reuse terms do not cover it. The downloads list each quotation with its source in third\_party\_quotations.

Also called: WOMAN-2; World Maternal Antifibrinolytic Trial\_2

Browse, life stage: Childbirth; Postpartum  
Browse, care area: Recovery after birth  

## In plain language

A large international trial in women with moderate or severe anaemia who gave birth vaginally. About 15,000 women were given either tranexamic acid or a dummy treatment (placebo) right after the birth, to see whether it prevents heavy bleeding. Neither the women nor the staff knew who got which. The medicine did not lower the risk of postpartum haemorrhage.

## Technical summary

International, randomised, double-blind, placebo-controlled trial (2024; PMID 39461792) in 34 hospitals in Nigeria, Pakistan, Tanzania and Zambia. Registrations named in the paper: ISRCTN62396133, NCT03475342 and PACTR201909735842379. Registry enrolment is 15,068 (actual); the abstract gives 7580 randomised to tranexamic acid and 7488 to placebo. Lead sponsor on the registry: London School of Hygiene and Tropical Medicine (no organisation record in this atlas yet). The abstract names the Bill & Melinda Gates Foundation and the Wellcome Trust as funders; the registry lists both as collaborators. Primary outcome: clinically diagnosed primary postpartum haemorrhage within 24 hours of randomisation. Result: no reduction (risk ratio 1.05, 95% CI 0.94 to 1.19).

## Key facts

- Design: International, randomised, double-blind, placebo-controlled trial. Women were randomly assigned (1:1) after vaginal birth, by selecting the lowest-numbered treatment pack from a box of identical packs. Participants, care givers and outcome assessors were masked.
- Phase: Phase 3
- Enrolled: 15068 women (registry enrollment, type ACTUAL) (enrolled count; World Maternal Antifibrinolytic Trial\_2, snapshot `maternal:ctgov-nct03475342-2026-10-14`, retrieved 2026-10-14); 7580 women assigned to tranexamic acid (randomized count; The effect of tranexamic acid on postpartum bleeding in women with moderate and severe anaemia (WOMAN-2): an international, randomised, double-blind, placebo-controlled trial, snapshot `maternal:pubmed-39461792-2026-10-14`, retrieved 2026-10-14); 7488 women assigned to placebo (randomized count; The effect of tranexamic acid on postpartum bleeding in women with moderate and severe anaemia (WOMAN-2): an international, randomised, double-blind, placebo-controlled trial, snapshot `maternal:pubmed-39461792-2026-10-14`, retrieved 2026-10-14)
- Started: 2019-08-24 (actual) (World Maternal Antifibrinolytic Trial\_2, snapshot `maternal:ctgov-nct03475342-2026-10-14`, retrieved 2026-10-14)
- Primary completion: 2023-09-20 (actual) (World Maternal Antifibrinolytic Trial\_2, snapshot `maternal:ctgov-nct03475342-2026-10-14`, retrieved 2026-10-14)
- Completion: 2023-10-29 (actual) (World Maternal Antifibrinolytic Trial\_2, snapshot `maternal:ctgov-nct03475342-2026-10-14`, retrieved 2026-10-14)
- Countries: Nigeria; Pakistan; Tanzania; Zambia (World Maternal Antifibrinolytic Trial\_2, snapshot `maternal:ctgov-nct03475342-2026-10-14`, retrieved 2026-10-14)
- Care setting: 34 hospitals across four countries (Nigeria, Pakistan, Tanzania and Zambia). (The effect of tranexamic acid on postpartum bleeding in women with moderate and severe anaemia (WOMAN-2): an international, randomised, double-blind, placebo-controlled trial, snapshot `maternal:pubmed-39461792-2026-10-14`, retrieved 2026-10-14)
- Registry status: "COMPLETED" (U.S. National Library of Medicine (ClinicalTrials.gov), snapshot `maternal:ctgov-nct03475342-2026-10-14`, retrieved 2026-10-14)

## Connected pages

- Tests tranexamic acid to prevent postpartum haemorrhage: Tranexamic acid to prevent bleeding after birth (`maternal:tranexamic-acid-pph-prevention`)
- The substance tested: Tranexamic acid (`maternal:tranexamic-acid`)
- Funder named in the abstract: Bill & Melinda Gates Foundation (`maternal:gates-foundation`)

## Provenance

Content hash: f19e7be50dfacddd32af0805402bf18fa901f8f85119d15836edfa47926f5ad6
Last substantive edit: 2026-10-14
Evidence last checked: 2026-10-14