November 4, 2026 · American journal of obstetrics & gynecology MFM · DOI: 10.1016/j.ajogmf.2026.102184

Tranexamic Acid Prophylaxis During Cesarean Delivery Among Patients with and Without Hypertension.

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This secondary analysis of the multicenter, placebo-controlled TXA trial asked whether prophylactic tranexamic acid during cesarean delivery works differently in patients with chronic or pregnancy-related hypertension than in those without. Among 10,995 participants (24.6% with hypertension), TXA's effect on the composite of transfusion or maternal death within 7 days was similar across groups (RR 0.84 with hypertension vs. 0.91 without; interaction p = 0.64), as were all secondary bleeding outcomes. The authors conclude that TXA's benefit does not depend on hypertensive status, supporting its use regardless of hypertension, though this was a non-prespecified analysis.

Mariam K Ayyash, Adam K Lewkowitz, Steven J Weiner, George R Saade, Samuel Parry, John M Thorp, Monica Longo, Alan T N Tita, Uma M Reddy, Suneet P Chauhan, Torri D Metz, Kara M Rood, Jennifer L Bailit, William A Grobman, Hyagriv N Simhan, Luis D Pacheco

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Tranexamic Acid Prophylaxis During Cesarean Delivery Among Patients with and Without Hypertension.

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