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In many resource-limited settings, postpartum hemorrhage (PPH) is a key cause of maternal death. Tranexamic acid is an inexpensive lysine analogue that inhibits fibrinolysis, thereby sustaining a developing clot. In an international study of tranexamic acid's effects on risk for maternal death from PPH, 20,060 women were treated with usual measures for PPH and randomized to receive tranexamic acid (1 g as a 10 mg/min intravenous infusion) or placebo. If bleeding continued for 30 more minutes, a second course of tranexamic acid or placebo could be administered. Most participants (96%) received routine uterotonic prophylaxis at delivery; women in both groups were treated with intrauterine tamponade, uterine compression sutures, uterine artery…