A 32-Year-Old Woman, Gravida 2 Para 1, Has a Spontaneous

A 32-year-old woman, gravida 2 para 1, has a spontaneous vaginal delivery.  Immediately after delivery of the placenta, the patient has a large amount of vaginal bleeding with passage of fist-sized clots, findings consistent with postpartum hemorrhage.  A dose of tranexamic acid is administered.  Which of the following is the most likely mechanism of action of this drug?

A) Increases vitamin K-dependent coagulation factor levels
B) Induces prostaglandin-mediated smooth muscle contraction
C) Inhibits plasminogen cleavage and prevents fibrin degradation
D) Promotes endothelial release of von Willebrand factor
E) Raises intracellular calcium levels in the uterine myometrium

Correct Answer:

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