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[Correspondence] Tranexamic acid for post-partum haemorrhage in the WOMAN trial

We read with interest the WOMAN trial1 and commend the investigators on this important multicentre, international, placebo-controlled trial. For a study to have external validity, its conditions need to be representative of a larger population. This study was mainly done in low-income and middle-income countries; thus, we have concerns about its generalisability. Many differences probably exist in the health-care systems (and disease burdens) between many countries included in the trial. Therefore, we do not think the results are immediately translatable to high-income countries.