ClinicalTrials.gg
RecruitingNCT06820177Updated Jun 15, 2026

Tranexamic Acid for Second Trimester Dilation and Evacuation and Bleeding Outcomes

A Phase 4 interventional study of Tranexamic Acid and Placebo in Abortion, Dilation and Evacuation and Hemorrhage, sponsored by University of California, San Diego. Recruiting at 3 sites in United States. Open to female participants aged 18 Years and older, including healthy volunteers. Per ClinicalTrials.gov, last updated 2026-06-15.

Sponsored by University of California, San Diego · Phase 4, Interventional, and Prevention

From the registry’s dates

  • Started Apr 2025; still recruiting 1 year 6 months later.
Phase
Phase 4
Study type
Interventional
Enrollment
276
Allocation
Randomized
Ages
18 Years and older
Sex
Female
01

Study summary

Although procedural abortion in the second trimester is extremely safe, hemorrhage is one of the leading causes of morbidity and mortality. Tranexamic acid (TXA) is used commonly in obstetrics to prevent or manage intrapartum or postpartum hemorrhage and has been associated with decreased mortality and decreased blood loss at the time of birth. Some guidelines are recommending the use of TXA for both the prevention and management of bleeding for abortion care. However, there are currently no published studies assessing the association between TXA and bleeding outcomes for abortion procedures. This study will involve a randomized, placebo-controlled trial of pregnant patients aged 18 and older desiring dilation and evacuation (D\&E) for abortion or fetal demise at 18-24 weeks gestation. The primary aim is to determine whether prophylactic TXA has an effect on the need for additional interventions to control bleeding at the time of D\&E. The secondary aim is to determine whether prophylactic TXA has an effect on the mean quantitative procedural blood loss.

02

Conditions studied

  • Abortion
  • Dilation and Evacuation
  • Hemorrhage
  • Prophylactic Tranexamic Acid Use
  • Blood Loss

Keywords

  • abortion
  • dilation and evacuation
  • TXA
  • hemorrhage
  • Tranexamic acid
  • D&E
03

In context

Dilatation, Pathologic

120 studies on the registry are indexed under Dilatation, Pathologic; 18 are open to participants now.

This study's planned enrollment of 276 is above the median of 82 across 84 interventional studies indexed under Dilatation, Pathologic.

Browse Dilatation, Pathologic studies →

Lead sponsor

University of California, San Diego is the lead sponsor of 980 studies on the registry; 195 are open to participants now.

Of its 113 completed or terminated interventional studies of FDA-regulated products, 71 (63%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
Female
Accepts healthy volunteers
Yes

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Able to understand and sign
  • Speaks English or Spanish language,
  • Requesting pregnancy termination or procedural management of fetal demise - Intrauterine pregnancy, 18 weeks 0 days and 24 weeks and 0 days gestation

Exclusion criteria

Exclusion Criteria:

  • History of or current thromboembolic event (deep vein thrombosis, stroke, pulmonary embolism)
  • History of coagulopathy
  • Anticoagulant use in the preceding five days
  • Severe renal impairment
  • Chorioamnionitis or sepsis
  • Suspected placenta accreta spectrum
  • Prophylactic uterotonics other than oxytocin given (or planned to be given) at the start of the D\&E
  • Known allergic reaction or to TXA
Terms in these criteria, in plain language(2)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

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Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

05

Study design

Phase
Phase 4
Primary purpose
Prevention
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Quadruple (Participant, Care provider, Investigator, Outcomes assessor)
Enrollment
276 participants (estimated)

Study arms

  • Placebo comparator
    Placebo

    10 mL of normal saline administered via IV at the start of the D\&E procedure

    Drug: Placebo

  • Active comparator
    Tranexamic acid

    1g tranexamic acid administered via IV at the start of the D\&E procedure

    Drug: Tranexamic Acid

Interventions

06

What researchers measure

Primary outcomes

  1. Composite outcome of excessive bleeding

    The use of any of the following interventions to manage excessive bleeding: at least one uterotonic medication given (i.e. methylergonovine maleate, carboprost tromethamine, misoprostol or additional oxytocin after the standard 30 units), blood transfusion, re-aspiration for bleeding or hematometra, intra-uterine balloon tamponade, uterine artery embolization, major surgery for bleeding, admission for bleeding, or prescription given for any uterotonic medication at discharge.

    Time frame: During the D&E procedure or immediately after

Secondary outcomes

  1. Mean intra-operative quantitative blood loss

    Blood loss measured from the start of the procedure (after removal of cervical dilators) until the end of the procedure (after removal of the speculum). Blood loss will be measured in mL by collecting the blood in a draped bag underneath the patient and weighing all gauze/chux used during the procedure.

    Time frame: During the D&E procedure

  2. Mean post-operative quantitative blood loss

    Any bleeding that occurs after speculum removal in the procedural room until the patient leaves clinic on the day of the procedure up to 4 hours following the procedure. The patient's menstrual pad(s) in the recovery room will be weighed.

    Time frame: on the day of the procedure up to 4 hours following the procedure

  3. Total number of interventions to control bleeding

    The total number of interventions performed within the primary composite outcome will be assessed.

    Time frame: During the D&E procedure or immediately after

  4. Individual interventions used to control bleeding for each participant

    Individual outcomes within the primary composite outcome will be assessed.

    Time frame: During the D&E procedure or immediately after

  5. Number of doses of uterotonics given

    We will assess the number of doses of uterotonics given for each participant

    Time frame: During the D&E procedure or immediately after

  6. Provider satisfaction with bleeding outcomes

    Each D\&E provider will be asked about their satisfaction with bleeding outcomes for the procedure using a 5 point Likert scale (from 0 being very unsatisfied to 5 being very satisfied).

    Time frame: Immediately after the D&E procedure

  7. Provider assessment of which treatment assignment they believe the participant received

    D\&E providers will be asked if they think the participant received the study drug or placebo.

    Time frame: Immediately after the D&E procedure

  8. Length of the procedure

    The length of the D\&E procedure will be recorded in minutes from the time the speculum is first instrument is placed in the uterus until the speculum is removed (minus any time for IUD placement).

    Time frame: During the D&E procedure

  9. Adverse events

    Adverse events will be assessed including: thromboembolic event, nausea, vomiting, dizziness or hypersensitivity will be ascertained on day of the procedure and by patient self report after

    Time frame: During the D&E procedure or immediately after

07

Study locations

3 of 3 sites recruiting
08

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Jun 15, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT06820177
Responsible party
Sarah Averbach, MD MAS (Associate Professor, University of California, San Diego) — Principal investigator
First posted
Feb 11, 2025
Start date
Apr 22, 2025
Primary completion
May 2027 (estimated)
Completion
May 2027 (estimated)
Last update
Jun 15, 2026

Study contacts

Karen Greiner, MD, MPH
Contact
familyplanningresearch@health.ucsd.edu
858-329-4464

Oversight

Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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