Tranexamic acid

 Postpartum haemorrhage has been a nightmare for obstetricians as well as the Anaesthesiologists since ages. Active management of the 3rd stage, in the form of intramuscular ergometrine at delivery of the anterior shoulder or 10-20 units of oxytocin infusion in 500 ml of normal saline and a controlled cord traction are practised routinely. Uterine atony, retained placentae and ruptured uteri are very often the real cause. But I also feel sincerely that morbidity in such cases do happen due to the late arrival at the hospital.As a last resort to control bleeding, major surgical interventions such as hysterectomy and bilateral uterine artery ligation are also required occasionally. In my experience, one drug which should not be forgotten in such cases is Tranexamic acid...Tranexamic acid is cheap, heat-resistant, easy to store  and it is proven to save lives. Col Pradeep Pendyala