PLG and pulmonary arterial hypertension: TXA is a competitive inhibitor of plasminogen activation, and it can reduce bleeding by inhibiting the enzymatic breakdown of fibrinogen and fibrin clots.59 While it is widely used in trauma and surgery, at the time of the 2012 Guideline Development Group (GDG) meeting there was no direct evidence on the effectiveness and safety of TXA when used for the treatment of PPH.